2021/05/16 更新

写真a

オグラ リヨウスケ
小倉 良介
OGURA Ryosuke
所属
医歯学総合病院 高次救命災害治療センター 特任助教
職名
特任助教
外部リンク

学位

  • 博士(医学) ( 2015年3月   新潟大学 )

研究分野

  • ライフサイエンス / 脳神経外科学

経歴

  • 新潟大学   医歯学総合病院 高次救命災害治療センター   特任助教

    2019年4月 - 現在

 

論文

  • [Surgical Case of Accidental Infantile Acute Subdural Hematoma Caused by Household Minor Head Trauma:Hyperperfusion during Postoperative Hemispheric Hypodensity, Namely "Big Black Brain"].

    Junichi Yoshimura, Manami Morikawa, Shunsuke Kumagai, Taiki Saito, Haruhiko Takahashi, Hidemoto Fujiwara, Ryosuke Ogura, Naoto Tsuchiya

    No shinkei geka. Neurological surgery48 ( 9 ) 841 - 847   2020年9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 experienced a case of an accidental infantile acute subdural hematoma caused by household minor head trauma(Nakamura type I intracranial hemorrhage)with postoperative hemispheric hypodensity lesion(Big Black Brain)whose pathophysiology was analyzed using perfusion MRI. A ten-month-old boy was admitted to our hospital in a comatose state. His mother revealed that the boy suffered a fall from a sofa bed. A CT scan indicated massive acute subdural hematoma in the left cerebral hemisphere. Emergency craniotomy and hematoma evacuation were performed. On postoperative day 3, CT revealed hemispheric hypodensity, and the boy suffered from status epilepticus. MRI on the following day showed widespread white matter hyperintensity in diffusion-weighted images, and MRA demonstrated dilation of the middle cerebral artery. Perfusion MRI using the dynamic susceptibility contrast method revealed a marked increase in cerebral blood flow in the left hemisphere. These abnormal MRI and MRA findings disappeared on postoperative day 13. Status epilepticus also improved upon administration of multi-antiepileptic drugs. Fundoscopy findings on postoperative day 3 showed small bilateral petechial or brush retinal hemorrhages. However, whole-body examination did not show any problems, and was consistent with the mother's account. Thus, we judged non-abusive head trauma. Although follow-up MRI showed diffuse atrophy of the left cerebral hemisphere, the boy aged well without obvious paresis or verbal developmental delay as judged by a follow-up more than a year later. Based on these results, we speculated that hyperperfusion caused by dilation of the cerebral artery was related to the postoperative hemispheric hypodensity, namely "Big Black Brain".

    DOI: 10.11477/mf.1436204281

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  • Reliable diagnosis of IDH-mutant glioblastoma by 2-hydroxyglutarate detection: a study by 3-T magnetic resonance spectroscopy. 査読 国際誌

    Manabu Natsumeda, Kunio Motohashi, Hironaka Igarashi, Takanori Nozawa, Hideaki Abe, Yoshihiro Tsukamoto, Ryosuke Ogura, Masayasu Okada, Tsutomu Kobayashi, Hiroshi Aoki, Hitoshi Takahashi, Akiyoshi Kakita, Kouichirou Okamoto, Tsutomu Nakada, Yukihiko Fujii

    Neurosurgical review41 ( 2 ) 641 - 647   2018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)  

    We have previously reported that reliable detection of 2-hydroxyglutarate (2HG) in isocitrate dehydrogenase (IDH)-mutant WHO grade 2 and 3 gliomas is possible utilizing 3.0-T single-voxel magnetic resonance spectroscopy (SVMRS). We set out to determine whether the same method could be applied to detect 2HG in IDH-mutant glioblastoma. Forty-four patients harboring glioblastoma underwent pre-operative MRS evaluation to detect 2HG and other metabolites. Presence of IDH-mutations was determined by IDH1 R132H immunohistochemical analysis and DNA sequencing of surgically obtained tissues. Six out of 44 (13.6%) glioblastomas were IDH-mutant. IDH-mutant glioblastoma exhibited significantly higher accumulation of 2HG (median 3.191 vs. 0.000 mM, p < 0.0001, Mann-Whitney test). A cutoff of 2HG = 0.897 mM achieved high sensitivity (100.0%) and specificity (92.59%) in determining IDH-mutation in glioblastoma. Glioblastoma with high 2HG accumulation did not have significantly longer overall survival than glioblastoma with low 2HG accumulation (p = 0.107, log-rank test). Non-invasive and reliable detection of 2HG in IDH-mutant glioblastoma was possible by 3.0-T SVMRS.

    DOI: 10.1007/s10143-017-0908-y

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  • Cerebral venous sinus thrombosis due to oral contraceptive use: Postmortem 3 T-MRI and autopsy findings. 査読

    Masahiro Uemuraa, Yoshihiro Tsukamoto, Yasuhisa Akaiwa, Masaki Watanabe, Ayako Tazawa, Sou Kasahara, Minoru Endou, Ryosuke Ogura, Kouichirou Okamoto, Yukihiko Fujii, Tsutomu Nakada

    Human Pathology ( 6 ) 32 - 36   2016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)  

    DOI: 10.1016/j.ehpc.2016.01.002

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  • Chemical Screening Identifies EUrd as a Novel Inhibitor Against Temozolomide-Resistant Glioblastoma-Initiating Cells. 査読 国際誌

    Yoshihiro Tsukamoto, Naoki Ohtsu, Smile Echizenya, Satoko Otsuguro, Ryosuke Ogura, Manabu Natsumeda, Mizuho Isogawa, Hiroshi Aoki, Satoshi Ichikawa, Masahiro Sakaitani, Akira Matsuda, Katsumi Maenaka, Yukihiko Fujii, Toru Kondo

    Stem cells (Dayton, Ohio)34 ( 8 ) 2016 - 25   2016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)   出版者・発行元:WILEY  

    Glioblastoma (GBM), one of the most malignant human cancers, frequently recurs despite multimodal treatment with surgery and chemo/radiotherapies. GBM-initiating cells (GICs) are the likely cell-of-origin in recurrences, as they proliferate indefinitely, form tumors in vivo, and are resistant to chemo/radiotherapies. It is therefore crucial to find chemicals that specifically kill GICs. We established temozolomide (the standard medicine for GBM)-resistant GICs (GICRs) and used the cells for chemical screening. Here, we identified 1-(3-C-ethynyl-β-d-ribopentofuranosyl) uracil (EUrd) as a selective drug for targeting GICRs. EUrd induced the death in GICRs more effectively than their parental GICs, while it was less toxic to normal neural stem cells. We demonstrate that the cytotoxic effect of EUrd on GICRs partly depended on the increased expression of uridine-cytidine kinase-like 1 (UCKL1) and the decreased one of 5'-nucleotidase cytosolic III (NT5C3), which regulate uridine-monophosphate synthesis positively and negatively respectively. Together, these findings suggest that EUrd can be used as a new therapeutic drug for GBM with the expression of surrogate markers UCKL1 and NT5C3. Stem Cells 2016;34:2016-2025.

    DOI: 10.1002/stem.2380

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  • Immunohistochemical profiles of IDH1, MGMT and P53: practical significance for prognostication of patients with diffuse gliomas. 査読 国際誌

    Ryosuke Ogura, Yoshihiro Tsukamoto, Manabu Natsumeda, Mizuho Isogawa, Hiroshi Aoki, Tsutomu Kobayashi, Seiichi Yoshida, Kouichiro Okamoto, Hitoshi Takahashi, Yukihiko Fujii, Akiyoshi Kakita

    Neuropathology : official journal of the Japanese Society of Neuropathology35 ( 4 ) 324 - 35   2015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)   出版者・発行元:WILEY-BLACKWELL  

    Genetic and epigenetic status, including mutations of isocitrate dehydrogenase (IDH) and TP53 and methylation of O(6) -methylguanine-DNA methyltransferase (MGMT), are associated with the development of various types of glioma and are useful for prognostication. Here, using routinely available histology sections from 312 patients with diffuse gliomas, we performed immunohistochemistry using antibodies specific for IDH1 mutation, MGMT methylation status, and aberrant p53 expression to evaluate the possible prognostic significance of these features. With regard to overall survival (OS), univariate analysis indicated that an IDH1-positive profile in patients with glioblastoma (GBM), anaplastic astrocytoma (AA), anaplastic oligoastrocytoma and oligodendroglioma, or a MGMT-negative profile in patients with GBM and AA were significantly associated with a favorable outcome. Multivariate analysis revealed that both profiles were independent factors influencing prognosis. The OS of patients with IDH1-positive/MGMT-negative profiles was significantly longer than that of patients with negative/negative and negative/positive profiles. A p53 profile was not an independent prognostic factor. However, for GBM/AA patients with IDH1-negative/MGMT-negative profiles, p53 overexpression was significantly associated with an unfavorable outcome. Thus, the immunohistochemical profiles of IDH1 and MGMT are of considerable significance in gliomas, and a combination of IDH1, MGMT and p53 profiles may be useful for prognostication of GBM/AA.

    DOI: 10.1111/neup.12196

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  • Cortico-cortical activity between the primary and supplementary motor cortex: An intraoperative near-infrared spectroscopy study 査読

    Masafumi Fukuda, Tetsuro Takao, Tetsuya Hiraishi, Hiroshi Aoki, Ryosuke Ogura, Yosuke Sato, Yukihiko Fujii

    Surgical Neurology International6 ( 1 )   2015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)   出版者・発行元:Medknow Publications  

    Background: The supplementary motor area (SMA) makes multiple reciprocal connections to many areas of the cerebral cortices, such as the primary motor cortex (PMC), anterior cingulate cortex, and various regions in the parietal somatosensory cortex. In patients with SMA seizures, epileptic discharges from the SMA rapidly propagate to the PMC. We sought to determine whether near-infrared spectroscopy (NIRS) is able to intraoperatively display hemodynamic changes in epileptic network activities between the SMA and the PMC. Case Descriptions: In a 60-year-old male with SMA seizures, we intraoperatively delivered a 500 Hz, 5-train stimulation to the medial cortical surface and measured the resulting hemodynamic changes in the PMC by calculating the oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) concentration changes during stimulation. No hemodynamic changes in the lateral cortex were observed during stimulation of the medial surface corresponding to the foot motor areas. In contrast, both HbO2 and HbR increased in the lateral cortex corresponding to the hand motor areas when the seizure onset zone was stimulated. In the premotor cortex and the lateral cortex corresponding to the trunk motor areas, hemodynamic changes showed a pattern of increased HbO2 with decreased HbR. Conclusions: This is the first reported study using intraoperative NIRS to characterize the epileptic network activities between the SMA and PMC. Our intraoperative NIRS procedure may thus be useful in monitoring the activities of cortico-cortical neural pathways such as the language system.

    DOI: 10.4103/2152-7806.153872

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  • Cortico-cortical activity between the primary and supplementary motor cortex: An intraoperative near-infrared spectroscopy study. 査読 国際誌

    Masafumi Fukuda, Tetsuro Takao, Tetsuya Hiraishi, Hiroshi Aoki, Ryosuke Ogura, Yosuke Sato, Yukihiko Fujii

    Surgical neurology international6   44 - 44   2015年

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    記述言語:英語  

    BACKGROUND: The supplementary motor area (SMA) makes multiple reciprocal connections to many areas of the cerebral cortices, such as the primary motor cortex (PMC), anterior cingulate cortex, and various regions in the parietal somatosensory cortex. In patients with SMA seizures, epileptic discharges from the SMA rapidly propagate to the PMC. We sought to determine whether near-infrared spectroscopy (NIRS) is able to intraoperatively display hemodynamic changes in epileptic network activities between the SMA and the PMC. CASE DESCRIPTIONS: In a 60-year-old male with SMA seizures, we intraoperatively delivered a 500 Hz, 5-train stimulation to the medial cortical surface and measured the resulting hemodynamic changes in the PMC by calculating the oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) concentration changes during stimulation. No hemodynamic changes in the lateral cortex were observed during stimulation of the medial surface corresponding to the foot motor areas. In contrast, both HbO2 and HbR increased in the lateral cortex corresponding to the hand motor areas when the seizure onset zone was stimulated. In the premotor cortex and the lateral cortex corresponding to the trunk motor areas, hemodynamic changes showed a pattern of increased HbO2 with decreased HbR. CONCLUSIONS: This is the first reported study using intraoperative NIRS to characterize the epileptic network activities between the SMA and PMC. Our intraoperative NIRS procedure may thus be useful in monitoring the activities of cortico-cortical neural pathways such as the language system.

    DOI: 10.4103/2152-7806.153872

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  • Accumulation of 2-hydroxyglutarate in gliomas correlates with survival: a study by 3.0-tesla magnetic resonance spectroscopy. 査読 国際誌

    Manabu Natsumeda, Hironaka Igarashi, Toshiharu Nomura, Ryosuke Ogura, Yoshihiro Tsukamoto, Tsutomu Kobayashi, Hiroshi Aoki, Kouichirou Okamoto, Akiyoshi Kakita, Hitoshi Takahashi, Tsutomu Nakada, Yukihiko Fujii

    Acta neuropathologica communications2   158 - 158   2014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)   出版者・発行元:BIOMED CENTRAL LTD  

    INTRODUCTION: Previous magnetic resonance spectroscopy (MRS) and mass spectroscopy studies have shown accumulation of 2-hydroxyglutarate (2HG) in mutant isocitrate dehydrogenase (IDH) gliomas. IDH mutation is known to be a powerful positive prognostic marker in malignant gliomas. Hence, 2HG accumulation in gliomas was assumed to be a positive prognostic factor in gliomas, but this has not yet been proven. Here, we analyzed 52 patients harboring World Health Organization (WHO) grade II and III gliomas utilizing 3.0-tesla MRS. RESULTS: Mutant IDH gliomas showed significantly higher accumulation of 2HG (median 5.077 vs. 0.000, p =0.0002, Mann-Whitney test). 2HG was detectable in all mutant IDH gliomas, whereas in 10 out of 27 (37.0%) wild-type IDH gliomas, 2HG was below the detectable range (2HG =0) (p =0.0003, chi-squared test). Screening for IDH mutation by 2HG analysis was highly sensitive (cutoff 2HG =1.489 mM, sensitivity 100.0%, specificity 72.2%). Gliomas with high 2HG accumulation had better overall survival than gliomas with low 2HG accumulation (p =0.0401, Kaplan-Meier analysis). DISCUSSION: 2HG accumulation detected by 3.0-tesla MRS not only correlates well with IDH status, but also positively correlates with survival in WHO grade II and III gliomas.

    DOI: 10.1186/s40478-014-0158-y

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  • Cerebral amyloid angiopathy-related leukoencephalopathy: successful steroid treatment for neurological deficits and subcortical white matter lesions partly involving the cortical gray matter 査読

    Neurology and Clinical Neuroscience2 ( 4 ) 119 - 121   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)  

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  • "Gliomatosis encephali" as a novel category of brain tumors by the first autopsy case report of gliomatosis cerebelli. 査読 国際誌

    Asa Nakahara, Toshikazu Yoshida, Masanobu Yazawa, Takashi Ehara, Jun Nakayama, Akiyoshi Kakita, Ryosuke Ogura, Mika Asakawa, Emi Suzuki-Kouyama, Kiyomitsu Oyanagi

    Neuropathology : official journal of the Japanese Society of Neuropathology34 ( 3 ) 295 - 303   2014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)   出版者・発行元:WILEY-BLACKWELL  

    Gliomatosis cerebri is a rare diffuse glioma that is neither mass-forming nor necrotic, and does not disrupt existing structures. Gliomatosis occurring in the cerebellum is known as gliomatosis cerebelli, and only three such cases examined by biopsy have been reported. Here we describe the first autopsy findings of a patient who was diagnosed as having gliomatosis in the cerebellum. Neuropathological examination identified the tumor cells as being positive for glial fibrillary acidic protein, vimentin and nestin, with atypical nuclei that were cashew-nut- or dishcloth-gourd-shaped. These tumor cells were dense in the right cerebellum, but also spread broadly throughout the brain including the left cerebrum and optic nerve. Mitotic figures were frequently seen in the cerebellum, brain stem and cerebrum. Scherer's secondary structures were evident not only in the cerebellum but also the cerebrum. No necrosis, microvascular proliferation or destruction of anatomical structures was detected in the whole brain. Differences in the origin of the tumors of the gliomatoses cerbri and cerebelli suggests these tumors are different types of brain tumors. Thus the findings support that the gliomatosis cerebelli is a novel type of brain tumor classification. Furthermore, by the similarities of the histological features among the tumors, it appears appropriate to establish a novel category of "gliomatosis encephali" which includes both gliomatosis cerebri and gliomatosis cerebelli.

    DOI: 10.1111/neup.12083

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  • Entrapment of the inferior horns of the lateral ventricle with enlargement of the bilateral choroid plexus. 査読 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)   出版者・発行元:WILEY-BLACKWELL  

    DOI: 10.1111/neup.12072

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  • Neuronal differentiation associated with Gli3 expression predicts favorable outcome for patients with medulloblastoma. 査読 国際誌

    Hiroaki Miyahara, Manabu Natsumeda, Junichi Yoshimura, Ryosuke Ogura, Kenichi Okazaki, Yasuko Toyoshima, Yukihiko Fujii, Hitoshi Takahashi, Akiyoshi Kakita

    Neuropathology : official journal of the Japanese Society of Neuropathology34 ( 1 ) 1 - 10   2014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)   出版者・発行元:WILEY-BLACKWELL  

    Medulloblastoma (MB) is a malignant cerebellar tumor arising in children, and its ontogenesis is regulated by Sonic Hedgehog (Shh) signaling. No data are available regarding the correlation between expression of Gli3, a protein lying downstream of Shh, and neuronal differentiation of MB cells, or the prognostic significance of these features. We re-evaluated the histopathological features of surgical specimens of MB taken from 32 patients, and defined 15 of them as MB with neuronal differentiation (ND), three as MB with both glial and neuronal differentiation (GD), and 14 as differentiation-free (DF) MB. Gli3-immunoreactivity (IR) was evident as a clear circular stain outlining the nuclei of the tumor cells. The difference in the frequency of IR between the ND+GD (94.4%) and DF (0%) groups was significant (P < 0.001). The tumor cells with ND showed IR for both Gli3 and neuronal nuclei. Ultrastructurally, Gli3-IR was observed at the nuclear membrane. The overall survival and event-free survival rates of the patients in the ND group were significantly higher than those in the other groups. The expression profile of Gli3 is of considerable significance, and the association of ND with this feature may be prognostically favorable in patients with MB.

    DOI: 10.1111/neup.12052

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  • Malignant peripheral nerve sheath tumor of the trigeminal nerve: clinicopathologic features in a young adult patient. 査読 国際誌

    Yoko Nakayama, Masatoshi Watanabe, Kenji Suzuki, Hiroyuki Usuda, Iwao Emura, Ryosuke Ogura, Atsushi Shiga, Yasuko Toyoshima, Hitoshi Takahashi, Tadashi Kawaguchi, Akiyoshi Kakita

    Neuropathology : official journal of the Japanese Society of Neuropathology33 ( 5 ) 541 - 6   2013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)  

    Malignant peripheral nerve sheath tumors (MPNSTs) arising from cranial nerves are rare and usually affect adults. Here we report the clinicopathologic features of a young adult patient with a trigeminal nerve MPNST, in whom another tumor involving the oculomotor nerve on the contralateral side was evident. The patient, an 18-year-old woman, had suffered recurrent paroxysmal sharp stabbing pain over her cheek and forehead on the right side for 1 month. A brain MRI study disclosed a mass, 35 mm in diameter, in the right Meckel's cave, and another mass, 10 mm in diameter, involving the intracranial portion of the left oculomotor nerve. Following gadolinium administration, the former and latter tumors exhibited strong and weak enhancement, respectively. The patient had no clinical stigmata characteristic of neurofibromatosis type 1. Following a tentative diagnosis of schwannoma, total resection of the trigeminal nerve tumor was performed. Histologically, the tumor consisted of highly cellular, spindle-shaped cells arranged in a fascicular pattern, with occasional mitotic figures, nuclear pleomorphism and necrosis. Immunohistochemically, the tumor cells showed variable intensities and frequencies of reactivity for S-100 protein, myelin basic protein, CD34, podoplanin and p53, but no reactivity for Smarcb1. Thus, the tumor exhibited features of MPNST. This case appears to provide information that is useful for accurate diagnosis and surgical planning in patients with bilateral or multiple cranial nerve tumors.

    DOI: 10.1111/neup.12004

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  • Epstein-Barr virus-associated primary central nervous system cytotoxic T-cell lymphoma. 査読 国際誌

    Ryosuke Ogura, Hiroshi Aoki, Manabu Natsumeda, Hiroshi Shimizu, Tsutomu Kobayashi, Tomohisa Saito, Jun Takizawa, Kouichirou Okamoto, Go Hasegawa, Hajime Umezu, Kouichi Ohshima, Hitoshi Takahashi, Yukihiko Fujii, Akiyoshi Kakita

    Neuropathology : official journal of the Japanese Society of Neuropathology33 ( 4 ) 436 - 41   2013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)   出版者・発行元:WILEY-BLACKWELL  

    Primary central nervous system lymphoma (PCNSL) expressing T-cell markers is rare, among which nasal-type extranodal NK/T-cell lymphoma is an extremely rare subtype associated with Epstein-Barr virus (EBV) infection. Here we report the clinicopathologic features of a case of EBV-associated PCNSL showing a cytotoxic T-cell phenotype. The patient, a 73-year-old woman, presented with rapidly progressive mental deterioration. Brain MRI revealed multiple lesions with swelling in the bilateral cerebral hemispheres, which were hypointense on T1-weighted images, hyperintense on T2-weighted and fluid-attenuated inversion recovery images, and slightly hyperintense on diffusion-weighted images. Biopsy specimens from the temporal region showed many medium-sized anaplastic lymphocytic cells with perivascular and angio-invasive patterns in the cortex. Immunohistochemically, the cells were positive for CD3, CD8, T-cell-restricted intracellular antigen-1 (TIA-1), granzyme B and perforin, but negative for CD56 and CD20. In situ hybridization revealed EBV-encoded RNAs in the tumor cell nuclei. A rearrangement study showed T-cell receptor γ-chain gene rearrangement with a clonal appearance. The patient died 6 months after surgery, and a general autopsy revealed no lymphoma cells outside the brain. These cellular profiles are inconsistent with those of extranodal NK/T-cell lymphoma, and have not been previously described. This case appears to represent an unusual CNS manifestation of EBV-associated T-cell lymphoma.

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  • [Intraoperative monitoring of motor evoked potentials during glioma removal]. 査読

    Masafumi Fukuda, Makoto Oishi, Tetsuro Takao, Tetsuya Hiraishi, Tsutomu Kobayashi, Hiroshi Aoki, Ryosuke Ogura, Akihiko Saito, Yukihiko Fujii

    No shinkei geka. Neurological surgery41 ( 3 ) 219 - 27   2013年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: To determine whether motor evoked potentials(MEPs)provide reliable monitoring of the motor system during resection of gliomas in or adjacent to the motor cortex or pyramidal tract. MATERIALS AND METHODS: MEP recording was performed during 64 operations in 55 patients harboring gliomas. Intraoperative MEP findings were classified into 3 groups:Group A was defined as having no significant MEP changes, Group B as having reversible MEP changes(?50% amplitude decrease or loss), and Group C as having irreversible changes. Postoperative motor function was evaluated according to the presence/absence of deterioration immediately after surgery and 1 month later, as compared to preoperative motor status RESULTS: Immediately after surgery, 13 of 39(33%)patients in Group A, 6 of 17(35%)in Group B, and 7 of 8(88%)in Group C experienced deterioration of motor function. One month after surgery, 4 of 39(10%)patients in Group A, 3 of 17(18%)in Group B, and 4 of 8(50%)showed deterioration of motor function. Both immediately(χ2=8.3, p<0.05)and 1 month(χ2=6.9, p<0.05)after surgery, MEP alterations correlated significantly with postoperative deterioration of motor function. Despite MEPs being stable throughout surgery(Group A), there were some patients with deterioration of motor function initially appearing to represent false negative monitoring. However, these deteriorations were confirmed to have been caused by secondary hemorrhage, venous return dysfunction, postoperative convulsion, or resection of the supplementary motor area. CONCLUSIONS: MEP monitoring provides reliable information on the motor system during glioma surgery. Although false negative MEP results may exist in some patients, most data were not influenced by intraoperative manipulation but rather were attributable to secondary postoperative events.

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  • Occurrence of metachronous pure germinomas long after treatment of a mixed germ cell tumor containing yolk sac tumor and germinoma. 査読 国際誌

    Shinya Jinguji, Kouichirou Okamoto, Junichi Yoshimura, Yuichiro Yoneoka, Ryousuke Ogura, Akihiko Saito, Yukihiko Fujii

    Journal of neurosurgery. Pediatrics11 ( 1 ) 68 - 73   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)  

    The authors report a rare case involving the occurrence of metachronous pure germinomas long after treatment of a mixed germ cell tumor (GCT) categorized as having a poor prognosis. A neurohypophysial germinoma occurred 4 years and 6 months after the initial treatment of a mixed pineal GCT containing a yolk sac tumor and a germinoma. Furthermore, intramedullary germinomas occurred 21 years after the initial treatment of the mixed GCT and 15 years after the second treatment of the neurohypophysial germinoma. The neurohypophysial germinoma was not confirmed histopathologically, but the intramedullary germinoma was histopathologically diagnosed as a pure germinoma. Serum α-fetoprotein levels at the second neurohypophysial and third intramedullary occurrences of the germinomas were less than 10 ng/ml. Therefore, no yolk sac components seemed to be contained in the tumors. The second neurohypophysial and third intramedullary germinomas might be recurrences of the germinoma component of the pineal mixed GCT, which consisted of a yolk sac tumor and a germinoma. However, it seems very unlikely that only the germinoma, categorized in the good prognosis group, would be the only one to recur. Hence, it seems plausible that both the second and the third occurrences of pure germinoma were de novo metachronous GCTs arising after the pineal mixed GCT was cured. The authors' case indicates the possibility of multicentric GCTs in the CNS.

    DOI: 10.3171/2012.9.PEDS12151

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  • Advantages of dose-dense methotrexate protocol for primary central nervous system lymphoma: comparison of two different protocols at a single institution. 査読

    Hiroshi Aoki, Ryosuke Ogura, Yoshihiro Tsukamoto, Masayasu Okada, Manabu Natsumeda, Mizuho Isogawa, Seiichi Yoshida, Yukihiko Fujii

    Neurologia medico-chirurgica53 ( 11 ) 797 - 804   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The efficacy and toxicity of high-dose methotrexate (HD-MTX)-based chemotherapy were retrospectively reviewed in patients with primary central nervous system lymphoma (PCNSL). All immunocompetent patients with histologically or radiographically diagnosed PCNSL treated between 2006 and 2012 at Niigata University Hospital were enrolled. Thirty-eight patients with a diagnosis of PCNSL were treated with one of two regimens during different time periods. During the first period, from 2006 to 2009, three 3-week cycles of MPV (MTX + procarbazine + vincristine) were administered (MPV3 group). In the second period, from 2010 to 2012, five 2-week cycles of MTX were administered (MTX5 group). High-dose cytarabine was used in both groups following HD-MTX-based chemotherapy. Whole-brain radiotherapy was used for patients who did not attain a complete response (CR) based on magnetic resonance images. In the MPV3 group, 20 out of 23 patients (87%) completed the planned treatment. The CR rate after chemotherapy was 30%, and 57% after radiation therapy. Thirteen out of 15 patients (87%) in the MTX5 group completed the planned treatment. The CR rates after chemotherapy and radiation therapy were 53% and 93%, respectively. Renal dysfunction was assessed by measuring creatinine clearance rates, which were very similar in both groups. In terms of hematologic toxicity and other adverse reactions, there was no significant difference between the two groups. In conclusion, dose-dense MTX chemotherapy improved outcome with acceptable toxicity compared with the treatment schedule for three cycles of MPV treatment.

    DOI: 10.2176/nmc.oa2013-0195

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  • Identification of a gene expression signature that predicts outcome in primary central nervous system lymphoma patients 査読

      18 ( 20 )   2012年

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    記述言語:英語  

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MISC

  • 聴神経腫瘍術後30年後に生じた後頭蓋窩髄外腫瘍の1例

    高橋 陽彦, 小倉 良介, 梨本 岳雄, 吉村 淳一

    信州医学雑誌68 ( 1 ) 62 - 63   2020年2月

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    記述言語:日本語   出版者・発行元:信州医学会  

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  • パーキンソン様症状で発症しOTAで全摘した大型pineocytomaの1例

    吉村 淳一, 高橋 陽彦, 藤原 秀元, 小倉 良介, 梨本 岳雄

    信州医学雑誌68 ( 1 ) 66 - 66   2020年2月

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    記述言語:日本語   出版者・発行元:信州医学会  

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  • A Case of Curative Onyx Embolization for Tentorial dAVF via Low-flow Feeders with Temporary Balloon Occlusion of High-flow Feeders 査読

    Ogura Ryosuke, Hasegawa Hitoshi, Kumagai Shunsuke, Takahashi Haruhiko, Fujiwara Hidemoto, Yoshimura Junichi, Fujii Yukihiko

    脳神経血管内治療14 ( 3 ) 112 - 117   2020年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本脳神経血管内治療学会  

    <p><b>Objective:</b> For curative Onyx embolization of dural arteriovenous fistulas (dAVF) with multiple feeders, it is essential to select the optimal target artery as well as to control the blood flow at the fistula point. We report a case of tentorial dAVF (TdAVF) treated by Onyx embolization under flow control using balloon catheters.</p><p><b>Case Presentation:</b> A 66-year-old male was admitted to our hospital for treatment of TdAVF detected incidentally by MRI, which revealed a dilated and tortuous vein around the cerebellum. Cerebral angiography demonstrated a TdAVF, fed mainly by bilateral middle meningeal arteries (MMA) and bilateral occipital arteries (OA), with the fistula point at the torcular and venous drainage to the two superior vermian veins (SVVs). Onyx 18 was injected from the low-flow feeder of the MMA under flow control by occluding the high-flow feeder of the OA using balloon catheters, obliterating the arteriovenous shunt.</p><p><b>Conclusion:</b> In treatment of TdAVF involving low- and high-flow feeders, Onyx embolization via the low-flow feeder with temporary balloon occlusion of other high-flow feeders is a useful method. This technique makes it easier for Onyx to penetrate the fistula point.</p>

    DOI: 10.5797/jnet.tn.2019-0053

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  • 発症時間不明の右内頸動脈閉塞に対して血栓回収術を施行した1例

    北川 幹太, 高橋 陽彦, 瀧野 透, 小倉 良介, 梨本 岳雄, 吉村 淳一

    長野赤十字病院医誌32   87 - 88   2019年12月

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    記述言語:日本語   出版者・発行元:長野赤十字病院  

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  • H3F3A G34Rが認められたcerebral hemispheric glioblastomaの1例

    塚本 佳広, 野澤 孝徳, 伊藤 絢子, 阿部 英明, 小倉 良介, 五十川 瑞穂, 棗田 学, 青木 洋, 岡本 浩一郎, 高橋 均, 藤井 幸彦, 柿田 明美

    新潟医学会雑誌131 ( 5 ) 313 - 313   2017年5月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • PXA with anaplastic features with sarcomatous componentと組織診断した前頭葉腫瘍の1例

    小倉 良介, 伊藤 絢子, 塚本 佳広, 五十川 瑞穂, 齋藤 理恵, 青木 洋, 岡本 浩一郎, 藤井 幸彦, 高橋 均, 柿田 明美

    The Kitakanto Medical Journal66 ( 2 ) 172 - 173   2016年5月

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    記述言語:日本語   出版者・発行元:北関東医学会  

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  • 3T-MRSを用いたグリオーマのIDH変異術前評価

    棗田 学, 五十嵐 博中, 野村 俊春, 小倉 良介, 塚本 佳広, 小林 勉, 青木 洋, 岡本 浩一郎, 中田 力, 藤井 幸彦

    CI研究37 ( 3-4 ) 105 - 110   2016年3月

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    記述言語:日本語   出版者・発行元:日本脳神経CI学会  

    2-ヒドロキシグルタル酸(2HG)は正常組織では殆ど検出されないが、IDH変異を有するグリオーマでは蓄積する。IDH変異を有するグリオーマ症例で、3T-single voxel Magnetic Resonance Spectroscopy(3T-SVMRS)を用いて、2HGを検出できることを報告した。その内容を、1)IDH変異と2HG、2)IDH変異を有するグリオーマの特異なbiology、3)3T-SVMRSの撮像条件、4)SVMRSによる2HGの検出、5)2HGの測定の臨床的意義、の5項目に分けて解説した。

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  • 【シーン別画像診断のいま-社会的要求への対応と課題[Scene Vol.9] オートプシー・イメージング(Ai)第五弾-社会インフラとしてのAiの普及と適切な活用に向けて-】医学・教育・情報などの視点から考察するオートプシー・イメージング(Ai) 新潟大学脳研究所の取り組み 3T MRIを用いたAiと病理解剖

    塚本 佳広, 小倉 良介, 渡辺 将樹, 岡本 浩一郎, 五十嵐 博中, 柿田 明美

    INNERVISION31 ( 1 ) 45 - 47   2015年12月

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    記述言語:日本語   出版者・発行元:(株)インナービジョン  

    新潟大学脳研究所は、脳神経外科と神経内科の臨床2科、神経病理部門、そして統合脳機能研究センターなどを有している。同センターの中田力名誉教授(当時・教授/センター長)の発案により実現した、3T MRIを用いた死後画像解析システムが稼働している。われわれのポリシーは、死亡時画像診断(以下、Ai)施行後直ちに病理解剖を行い、画像情報と組織所見を統合して病態理解につなげようとするものである。Aiを剖検の代替手段として行おうとするものではない。本稿では、神経疾患を対象として当研究所が取り組んでいる死後画像解析システムと病理解剖について紹介する。(著者抄録)

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  • 悪性星細胞腫瘍におけるp53の発現意義

    小倉 良介, 塚本 佳広, 棗田 学, 五十川 瑞穂, 青木 洋, 小林 勉, 吉田 誠一, 高橋 均, 柿田 明美, 藤井 幸彦

    Brain Tumor Pathology32 ( Suppl. ) 105 - 105   2015年5月

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    記述言語:日本語   出版者・発行元:日本脳腫瘍病理学会  

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  • グリオーマ幹細胞研究の取り組み

    塚本 佳広, 小倉 良介, 岡田 正康, 棗田 学, 五十川 瑞穂, 青木 洋, 吉田 誠一, 藤井 幸彦, 小林 勉

    新潟医学会雑誌128 ( 11 ) 610 - 610   2014年11月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • "Gliomatosis encephali'' as a Novel Category of Brain Tumors: The First Autopsy Case Report of Gliomatosis Cerebelli

    Asa Nakahara, Toshikazu Yoshida, Masanobu Yazawa, Takashi Ehara, Jun Nakayama, Akiyoshi Kakita, Ryosuke Ogura, Mika Asakawa, Emi Suzuki-Kouyama, Kiyomitsu Oyanagi

    JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY73 ( 6 ) 632 - 632   2014年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • 【マルチモダリティによるHead & Neck Imaging 2014 臨床編 最新技術が臨床にもたらす変革とベネフィット】MRIのストラテジー&アウトカム 臨床施設からの報告 脳腫瘍 神経膠腫の診断・鑑別診断、術前情報取得におけるMRIの有用性

    岡本 浩一郎, 野村 俊春, 倉部 聡, 塚本 佳広, 棗田 学, 小倉 良介, 五十川 瑞穂, 青木 洋, 金沢 勉, 淡路 正則, 稲川 正一, 五十嵐 博中, 藤井 幸彦

    INNERVISION29 ( 5 ) 21 - 24   2014年4月

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    記述言語:日本語   出版者・発行元:(株)インナービジョン  

    脳腫瘍の画像診断は、(1)存在・局在診断(腫瘍性病変の検出と部位・進展範囲の把握)、(2)質的(腫瘍の組織型と悪性度)診断推定と鑑別診断、(3)術前情報取得、(4)術後評価、(5)治療効果判定のいずれにも大きく関与する。CTは、(1)(2)における腫瘍の石灰化の検出、(3)での頭蓋骨描出などにおいて有用であるが、MRI情報はすべての過程において重要である。本稿では、神経膠腫の(2)(3)における当施設でのMRI撮像について、症例を提示して示す。なお、3T MRI装置を用いたMRスペクトロスコピー(MRS)、arterial spin labeling(ASL)法による灌流MRI、拡散テンソル画像(DTI)、three dimensional anisotropy contrast(3D-AC)法による神経線維描出は、本学脳研究所統合脳機能研究センターの協力を得て行っている。(著者抄録)

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  • 大きな転移性脳腫瘍に対するガンマナイフによる2分割定位照射の有用性と安全性

    五十川 瑞穂, 佐藤 光弥, 小倉 良介, 棗田 学, 青木 洋, 藤井 幸彦

    新潟医学会雑誌128 ( 3 ) 146 - 146   2014年3月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • 出血性梗塞を疑うも診断に苦慮した1例

    棗田 学, 安藤 和弘, 岡田 正康, 渡邉 徹, 小倉 良介, 岡本 浩一郎, 牧野 邦比古

    新潟医学会雑誌128 ( 1 ) 37 - 38   2014年1月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • マウス脳腫瘍モデルを用いた脳腫瘍幹細胞の分離培養法の確立

    五十川 瑞穂, 塚本 佳広, 小倉 良介, 岡田 正康, 棗田 学, 青木 洋, 吉田 誠一, 藤井 幸彦

    新潟県医師会報 ( 766 ) 10 - 12   2014年1月

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    記述言語:日本語   出版者・発行元:新潟県医師会  

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  • 硬膜への播種性再発と腫瘍内出血を繰り返した膠肉腫の一例

    青木 洋, 小倉 良介, 塚本 佳広, 棗田 学, 小林 勉, 岡本 浩一郎, 吉田 誠一, 柿田 明美, 高橋 均, 藤井 幸彦

    Brain Tumor Pathology30 ( Suppl. ) 157 - 157   2013年5月

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    記述言語:日本語   出版者・発行元:日本脳腫瘍病理学会  

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  • 神経膠腫摘出標本における免疫染色法を用いたIDH1 mutationの評価と予後解析

    小倉 良介, 棗田 学, 青木 洋, 小林 勉, 柿田 明美, 高橋 均, 藤井 幸彦

    新潟医学会雑誌127 ( 3 ) 172 - 172   2013年3月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • 神経膠腫におけるIDH1 mutationと予後との関連 摘出組織を用いた免疫組織化学的検討

    小倉 良介, 棗田 学, 青木 洋, 小林 勉, 高橋 均, 柿田 明美, 藤井 幸彦

    Brain Tumor Pathology29 ( Suppl. ) 190 - 190   2012年5月

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    記述言語:日本語   出版者・発行元:日本脳腫瘍病理学会  

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  • 脳腫瘍に対する治療戦略の新しい展望 分子解析に基づく臨床試験 神経膠腫の擬似進行ではIDH1変異ではなくnegative MGMT発現が高頻度に発生する(New Horizon of Treatment Strategy for Brain Tumor: Clinical Trial Based on Molecular Analyses High Incidence of Negative MGMT Expression but not IDH1 Mutation in Pseudoprogressio

    棗田 学, 小倉 良介, 青木 洋, 小林 勉, 宇塚 岳夫, 柿田 明美, 高橋 均, 藤井 幸彦

    Brain Tumor Pathology29 ( Suppl. ) 151 - 151   2012年5月

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    記述言語:英語   出版者・発行元:日本脳腫瘍病理学会  

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  • 17 PseudoprogressionにおけるMGMT発現の検討(I.一般演題,第58回新潟脳神経外科懇話会)

    棗田 学, 小倉 良介, 青木 洋, 小林 勉, 宇塚 岳夫, 藤井 幸彦

    新潟医学会雑誌 = 新潟医学会雑誌126 ( 2 ) 117 - 117   2012年2月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • Solitary metastasis in the hyopthalamus associated with hypopituitarism and chiasmal syndrome

    Tetsuro Tamura, Takashi Kon, Satoshi Aoki, Ryosuke Ogura

    ENDOCRINE JOURNAL57   S511 - S511   2010年3月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:JAPAN ENDOCRINE SOC  

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共同研究・競争的資金等の研究

  • ボリノスタットによるオートファジー誘導とMGMT抑制効果に関する研究

    研究課題/領域番号:26861141  2014年04月 - 2016年03月

    日本学術振興会  科学研究費助成事業 若手研究(B)  若手研究(B)

    小倉 良介

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    配分額:3510000円 ( 直接経費:2700000円 、 間接経費:810000円 )

    ヒストン脱アセチル化酵素阻害剤であるボリノスタットには、悪性神経膠腫の薬剤耐性のひとつであるMGMT活性を抑制する作用を有するが、その機序は不明な点が多い。本研究では、オートファジーとの関係に注目し、ボリノスタットによるMGMT活性を抑制する機序について検討した。MGMTがテモゾロミド耐性を発揮するためには、核内に局在している必要がある可能性が示唆された。さらに核外で過剰に発現したMGMT蛋白は、シャペロン介在性オートファジーで分解される可能性が示唆された。本研究を通して、MGMT蛋白をはじめとする薬剤耐性酵素の局在を変化させることは、薬剤耐性克服の新たな治療戦略である可能性が示唆された。

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