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Nakayama N, Yamada T, Yano H, Takei H, Ohe N, Miwa K, Shinoda J, Iwama T. Prediction of nuclide accumulation spread based on the volume of enhancing magnetic resonance imaging lesion in glioblastoma patients. J Neurosurg Sci 2024; 68:164-173. [PMID: 34647709 DOI: 10.23736/s0390-5616.21.05353-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND 11C-methionine-PET (MET) and Thallium-201 chloride-SPECT (TL) are useful for predictive proliferation ability and tumor invasion range identification in glioma patients, however they are not always possible in any hospital or country. Our study aimed to assess whether the range of MET and Tl accumulation could be predicted from the contrast-enhanced lesions in Gadolinium (Gd)-T1 weighted magnetic resonance image in glioblastoma multiforme (GBM) patients. METHODS In 25 cases, the MET-area, TL-area, O-area where MET and TL overlap, and all accumulation area (AA-area) were measured in the same axial cross section as the Gd enhanced maximum area (Gd-area). This tracing operation was repeated with all axial fusion slices, and each volume was also measured (Gd-V, MET-V, TL-V, O-V, AA-V). RESULTS The maximum accumulation distance of MET and TL beyond the Gd-area was limited to within 30 mm, 35 mm, respectively. Significant positive correlations were showed in all combinations with Gd-area: MET-area (r=0.851, P<0.0001), TL-area (r=0.955, P<0.0001), O-area (r=0.935, P<0.0001) and AA-area (r=0.893, P<0.0001), respectively. All combinations with Gd-V showed significant positive correlation: MET-V (r=0.867, P<0.0001), TL-V (r=0.952, P<0.0001), O-V (r=0.935, P<0.0001) and AA-V (r=0.897, P<0.0001), respectively. CONCLUSIONS Approximate tumor volume Gd-V can be calculated using the formula A * B * C / 2, where A, B, and C represent the dimensions of Gd-enhanced lesion in 3 axes perpendicular to each other. The nuclide accumulation predictive table created using the obtained linear approximation functions can be used to predict the average tumor invasion range from the Gd-V without preoperative nuclear examinations.
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Affiliation(s)
- Noriyuki Nakayama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan -
| | - Tetsuya Yamada
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hirohito Yano
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo City, Gifu, Japan
| | - Hiroaki Takei
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo City, Gifu, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiro Miwa
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo City, Gifu, Japan
| | - Jun Shinoda
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo City, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
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Yano H, Miwa K, Nakayama N, Maruyama T, Ohe N, Ikuta S, Ikegame Y, Yamada T, Takei H, Owashi E, Ohmura K, Yokoyama K, Kumagai M, Muragaki Y, Iwama T, Shinoda J. Differentiation of astrocytoma between grades II and III using a combination of methionine positron emission tomography and magnetic resonance spectroscopy. World Neurosurg X 2023; 19:100193. [PMID: 37123626 PMCID: PMC10141501 DOI: 10.1016/j.wnsx.2023.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
Objective This study aimed to establish a method for differentiating between grades II and III astrocytomas using preoperative imaging. Methods We retrospectively analyzed astrocytic tumors, including 18 grade II astrocytomas (isocitrate dehydrogenase (IDH)-mutant: IDH-wildtype = 8:10) and 56 grade III anaplastic astrocytomas (37:19). We recorded the maximum methionine (MET) uptake ratios (tumor-to-normal: T/N) on positron emission tomography (PET) and three MRS peak ratios: choline (Cho)/creatine (Cr), N-acetyl aspartate (NAA)/Cr, and Cho/NAA, between June 2015 and June 2020. We then evaluated the cut-off values to differentiate between grades II and III. We compared the grading results between contrast enhancement effects on MR and combinational diagnostic methods (CDM) on a scatter chart using the cutoff values of the T/N ratio and MRS parameters. Results The IDH-mutant group showed significant differences in the Cho/NAA ratio between grades II and III using univariate analysis; however, multiple regression analysis results negated this. The IDH-wildtype group showed no significant differences between the groups. Contrast enhancement effects also showed no significant differences in IDH status. Accordingly, regardless of the IDH status, no statistically independent factors differentiated between grades II and III. However, CDMs showed higher sensitivity and negative predictive value in distinguishing them than MRI contrast examinations for both IDH statuses. We demonstrated a significantly higher diagnostic rate of grade III than of grade II with CDM, which was more striking in the IDH-mutant group than in the wild-type group. Conclusions CDM could be valuable in differentiating between grade II and III astrocytic tumors.
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
- Department of Clinical Brain Science, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
- Corresponding author. Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan.
| | - Kazuhiro Miwa
- Department of Neurosurgery, Central Japan International Medical Center, 1-1 Kenkou-no-machi, Minokamo City, 505-8510, Japan
| | - Noriyuki Nakayama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Takashi Maruyama
- Department of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Soko Ikuta
- Department of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yuka Ikegame
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
- Department of Clinical Brain Science, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Tetsuya Yamada
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Hiroaki Takei
- Department of Neurosurgery, Central Japan International Medical Center, 1-1 Kenkou-no-machi, Minokamo City, 505-8510, Japan
| | - Etsuko Owashi
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
| | - Kazufumi Ohmura
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
| | - Kazutoshi Yokoyama
- Department of Neurosurgery, Central Japan International Medical Center, 1-1 Kenkou-no-machi, Minokamo City, 505-8510, Japan
| | - Morio Kumagai
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
| | - Yoshihiro Muragaki
- Department of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Jun Shinoda
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
- Department of Clinical Brain Science, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
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Yagasaki A, Miyase T, Sakai S, Mochizuki K, Sakaguchi H, Yagasaki T, Ohe N, Yasue S, Endo S, Ozeki M. Two Pediatric Patients with Acute Acquired Comitant Esotropia as the First Symptom of Brainstem Tumor: A Case Report. Case Rep Ophthalmol 2023; 14:613-619. [PMID: 37946847 PMCID: PMC10631780 DOI: 10.1159/000534709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023] Open
Abstract
Introduction Acute acquired comitant esotropia (AACE) is an acquired strabismus with uncrossed sudden-onset diplopia due to esodeviation, comitant esotropia without accommodation factor, or paretic eye movement. The diagnosis of AACE entails differentiation from incomitant esotropia caused by abnormalities in the central nervous system. We present 2 pediatric patients with AACE as the first symptom of brainstem tumor. Case Presentation The 2 patients were aware of their diplopia and had no other neurological abnormalities. There were no special findings in the anterior segment, ocular media, or fundus. Esotropia with a difference of no more than 10Δ between distant and near fixations was observed. Eye movements were normal, and Hess red-green test under prism neutralization did not reveal abduction restriction. The presumed cause of AACE in both patients was excessive use of digital displays, and brain magnetic resonance imaging (MRI) was performed to confirm the absence of neurological abnormality. Using MRI, a definitive diagnosis of AACE was made based on comitant esotropia associated with diffuse median glioma and medullary pilocytic astrocytoma without abducens nerve palsy. Conclusion Although the incidence of AACE caused by brainstem tumors may be low, it is necessary to perform head imaging to confirm etiology. Furthermore, Hess red-green test under prism neutralization is considered important for the differentiation of abducens nerve palsy.
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Affiliation(s)
- Ayaka Yagasaki
- Department of Ophthalmology, Gifu Prefectural General Medical Center, Gifu, Japan
- Department of Ophthalmology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Taishi Miyase
- Department of Ophthalmology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Shota Sakai
- Department of Ophthalmology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Kiyofumi Mochizuki
- Department of Ophthalmology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Hirokazu Sakaguchi
- Department of Ophthalmology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | | | - Naoyuki Ohe
- Department of Neurosurgery, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Shiho Yasue
- Department of Pediatrics, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Saori Endo
- Department of Pediatrics, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Michio Ozeki
- Department of Pediatrics, Gifu Prefectural General Medical Center, Gifu, Japan
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Nakayama N, Yamada T, Ohe N, Yano H, Iwama T. ACT-26 PATTERN OF RECURRENCE IN NEWLY DIAGNOSED GLIOBLASTOMA TREATED WITH PHOTODYNAMIC THERAPY. Neurooncol Adv 2022. [PMCID: PMC9719299 DOI: 10.1093/noajnl/vdac167.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Abstract
In 2016, photodynamic therapy (PDT) system using talaporfin sodium was introduced to our hospital. By December 2021, we have experienced 22 cases (15 males, 7 females, 57.9±18.6 years old) of newly diagnosed glioblastoma (GBM) treated with PDT. The recurrence pattern of 22 cases was retrospectively examined. In August 2022, 7 cases are still alive. Laser irradiation was performed at an average of 7.6±3.4 sites. Tumor localization was solitary and superficial in 14 cases. Extent of tumor resection was 89.3±18.5%, and the postoperative KPS was 86.4±15.0%. Median PFS was 11 months, median OS was 18 months, and 5 patients survived for more than 3 years. Recurrences were observed in 16 cases, and the recurrence types were local (LR) in 9 cases, distant (DR) in 3 cases, and both in 4 cases. Two of the remaining 6 cases, which were judged to have no recurrence at present, had Gd-enhancing lesions locally and were judged to have LR. Therefore, re-resection was performed in both cases, but the pathological diagnosis was gliosis. Fujita et al. (J Neurooncol 155:81-92, 2021) reported that acute response of high-grade glioma to PDT can be detected as linear transient hyperintense signal (LTHS) on diffusion-weighted imaging (DWI), and that All of the LRs arose from areas that did not show LTHS on DWI obtained on day 1 after PDT. Furthermore, they reported that this characteristic finding is useful for monitoring LR after PDT. In our cases, 3 DRs and 4 existing long-term survivors (including 2 with local gliosis) showed nearly LTHS throughout the resected wall. On the other hand, partial absence of LTHS was confirmed in 13 cases containing LR. PDT provides effective local control, but it requires careful irradiation planning to avoid missing areas of irradiation, and LTHS on DWI could indicate whether effective irradiation has been achieved.
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Affiliation(s)
- Noriyuki Nakayama
- Department of Neurosurgery, Gifu University Graduate School of Medicine , Gifu , Japan
| | - Tetsuya Yamada
- Department of Neurosurgery, Gifu University Graduate School of Medicine , Gifu , Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine , Gifu , Japan
| | - Hirohito Yano
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital , Minokamo City, Gifu , Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine , Gifu , Japan
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Terashima K, Sonehara K, Kimura Y, Nakano Y, Ozawa T, Takahashi M, Suzuki K, Fujii T, Matsushita Y, Tomiyama A, Suzuki T, Yamaguchi S, Miwa T, Sasaki H, Kitagawa M, Ohe N, Fukai J, Ogiwara H, Kawamura A, Miyawaki S, Matsuda F, Kiyakawa N, Ichimura K, Nishikawa R, Okada Y. BOT-3 GENOME-WIDE ASSOCIATION STUDY OF INTRACRANIAL GERM CELL TUMORS: A COMMON DELETION AT BAK1 ATTENUATES THE ENHANCER ACTIVITY AND CONFERS RISK FOR THE BRAIN TUMORS IN CHILDREN ADOLESCENTS AND YOUNG ADULTS. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Abstract
Intracranial germ cell tumors (IGCTs) are rare brain tumors that mainly occur in children, adolescents and young adults with a particularly high incidence in East Asian populations. The biological basis of these tumors is still largely unknown. We conduct a genome-wide association study (GWAS) of 133 patients with IGCTs and 762 controls of Japanese ancestry by using Infinium Asian Screening Array and other molecular biology methods. A common 4-bp deletion polymorphism in an enhancer adjacent to BAK1 is significantly associated with the disease risk (rs3831846; P = 2.4 × 10−9, odds ratio = 2.46 [95% CI: 1.83-3.31], minor allele frequency = 0.43). Rs3831846 is in strong linkage disequilibrium with a testicular GCTs susceptibility variant rs210138. Expression quantitative trait locus (eQTL) analysis using the GTEx dataset reveals that the risk allele of rs3831846 has a down-regulating effect on BAK1 expression in a wide range of tissues. Further in-vitro reporter assays reveal rs3831846 to be a functional variant attenuating the enhancer activity. BAK1 is a pro-apoptotic member of the BCL-2 family, thus our results suggested that the risk allele may contribute to IGCTs predisposition through down-regulating BAK1 expression. Risk alleles of testicular GCTs derived from the European GWAS show significant positive correlations in the effect sizes with the Japanese IGCTs GWAS (P = 1.3 × 10-4, Spearman’s ρ = 0.48). Of the 57 loci, 11 exhibit significant association with IGCTs and these loci were implicated in a broad range of biological pathways, including KIT/KITLG signaling, apoptosis regulation, and telomerase activity. The risk allele frequency of rs3831846 is higher in east Asia than Europe (0.49 vs. 0.20), which may provide a partial explanation for the ethnic difference in incidence. Nevertheless, our results suggest the shared genetic susceptibility of GCTs beyond ethnicity and primary sites.
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Affiliation(s)
- Keita Terashima
- Division of Neuro-Oncology, Children's Cancer Center, National Center for Child Health and Development , Tokyo , Japan
| | - Kyuto Sonehara
- Department of Statistical Genetics, Osaka University Graduate School of Medicine , Suita , Japan
| | - Yui Kimura
- Division of Neuro-Oncology, Children's Cancer Center, National Center for Child Health and Development , Tokyo , Japan
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute , Tokyo , Japan
| | - Yoshiko Nakano
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute , Tokyo , Japan
| | - Tatsuya Ozawa
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute , Tokyo , Japan
| | - Meiko Takahashi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine , Kyoto , Japan
| | - Ken Suzuki
- Department of Statistical Genetics, Osaka University Graduate School of Medicine , Suita , Japan
| | - Takashi Fujii
- Department of Neurosurgery, National Defense Medical College , Tokorozawa , Japan
- Department of Brain Disease Translational Research, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Yuko Matsushita
- Department of Brain Disease Translational Research, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Arata Tomiyama
- Department of Neurosurgery, National Defense Medical College , Tokorozawa , Japan
- Department of Brain Disease Translational Research, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Tomonari Suzuki
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center , Hidaka , Japan
| | - Shigeru Yamaguchi
- Department of Neurosurgery, Faculty of Medicine, Hokkaido University , Sapporo , Japan
| | - Tomoru Miwa
- Department of Neurosurgery, Keio University School of Medicine , Tokyo , Japan
| | - Hikaru Sasaki
- Department of Neurosurgery, Keio University School of Medicine , Tokyo , Japan
| | - Masashi Kitagawa
- Department of Neurosurgery, Shizuoka Children's Hospital , Shizuoka , Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Graduate School of Medicine, Gifu University , Gifu , Japan
| | - Junya Fukai
- Department of Neurological Surgery, Wakayama Medical University School of Medicine , Kimiidera , Japan
| | - Hideki Ogiwara
- Division of Neurosurgery, National Center for Child Health and Development , Tokyo , Japan
| | - Atsufumi Kawamura
- Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital , Kobe , Japan
| | - Satoru Miyawaki
- Department of Neurosurgery, Faculty of Medicine, the University of Tokyo , Tokyo , Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine , Kyoto , Japan
| | - Nobutaka Kiyakawa
- Division of Neuro-Oncology, Children's Cancer Center, National Center for Child Health and Development , Tokyo , Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute , Tokyo , Japan
- Department of Brain Disease Translational Research, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center , Hidaka , Japan
| | - Yukinori Okada
- Department of Statistical Genetics, Osaka University Graduate School of Medicine , Suita , Japan
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Ohe N. [Suprasellar Tumor-Craniotomy]. No Shinkei Geka 2022; 50:1332-1339. [PMID: 36426533 DOI: 10.11477/mf.1436204699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Surgical procedures for pediatric suprasellar tumors include craniotomy and nasal surgery. Craniotomies are increasingly performed with a microscope, exoscope, and endoscope, while nasal surgery is performed mainly with endoscopes. In some cases, craniotomy and nasal surgery are performed together. This article describes craniotomy. Due to its large surgical field, craniotomy is often chosen for large tumors in the suprasellar region, tumors located above the optic chiasm and optic nerve, tumors extending laterally, and hypervascularized tumors. It is the surgical technique of choice for many neurosurgeons because they are familiar with it. Craniotomies include bilateral frontal and frontotemporal craniotomies. The interhemispheric and subfrontal approaches involve bilateral frontal craniotomy, pterional approach, orbitozygomatic approach, subtemporal approach using temporal-occipital craniotomy, and transpetrosal transtentorial approach using temporal-occipital-suboccipital craniotomy. The approach was selected based on the direction of tumor extension and relationship between the tumor and optic nerve, optic chiasm, and blood vessels. This paper describes the frequently used interhemispheric and pterional approaches based on our experience.
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Affiliation(s)
- Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine
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Kobayashi H, Enomoto Y, Yamada T, Egashira Y, Nakayama N, Ohe N, Iwama T. Perianeurysmal cyst formation in the brainstem after coil embolization: illustrative case. Journal of Neurosurgery: Case Lessons 2022; 3:CASE21690. [PMID: 35734607 PMCID: PMC9204926 DOI: 10.3171/case21690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/29/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Perianeurysmal cysts in the brainstem after endovascular coil embolization are rare, and their underlying mechanism remains unclear. The authors reported a case of a postcoiling perianeurysmal cyst that developed 6 years after endovascular coil embolization for a ruptured aneurysm and reviewed the related literature. OBSERVATIONS A 77-year-old woman had a history of subarachnoid hemorrhage 6 years earlier. The ruptured large left vertebral artery–posterior inferior cerebellar artery aneurysm was treated with endovascular coil embolization. Two years later, the aneurysm regrew and perianeurysmal brainstem edema was detected on magnetic resonance imaging (MRI); stent-assisted coil embolization combined with low-flow bypass was performed. Follow-up MRI showed that the perianeurysmal edema gradually transformed into a perianeurysmal cyst over the next 3 years. Finally, the perianeurysmal cyst caused gait disturbance with ataxia, and the patient received cyst puncture. After surgery, the symptom was immediately improved. LESSONS The authors reported, for the first time, postcoiling of perianeurysmal cyst formation treated by cyst puncture. If perianeurysmal edema is detected after endovascular coil embolization, especially for large aneurysms, it is necessary to consider progression to cyst formation and follow up over time. In addition, cyst puncture is effective, depending on the symptoms and the lesion.
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Affiliation(s)
- Hiroki Kobayashi
- Department of Neurosurgery, Gifu University Hospital, Gifu, Japan
| | - Yukiko Enomoto
- Department of Neurosurgery, Gifu University Hospital, Gifu, Japan
| | - Tetsuya Yamada
- Department of Neurosurgery, Gifu University Hospital, Gifu, Japan
| | - Yusuke Egashira
- Department of Neurosurgery, Gifu University Hospital, Gifu, Japan
| | | | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Hospital, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Hospital, Gifu, Japan
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Ninomiya H, Ozeki M, Nozawa A, Yasue S, Endo S, Inuzuka M, Obara N, Mochizuki K, Kawaguchi M, Kaneko Y, Ohe N, Aoki Y, Matsuo M, Iwama T, Ohnishi H. A rare pediatric case of McCune-Albright syndrome with acute visual disturbance: Case report. Medicine (Baltimore) 2022; 101:e28815. [PMID: 35147121 PMCID: PMC8830878 DOI: 10.1097/md.0000000000028815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/25/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE McCune-Albright syndrome (MAS) is a rare disorder characterized by clinical findings, which includes fibrous dysplasia (FD). FD is a benign tumor that leads to increased rates of bone fracture. In some MAS cases with FD, facial deformities, severe pain, and orbital neuropathies are complicated. Aneurysmal bone cyst (ABC) is a benign bone tumor and rare complication of FD. PATIENT CONCERNS A 9-year-old boy was admitted to our hospital because of acute visual disturbance. DIAGNOSIS AND INTERVENTIONS The patient was clinically diagnosed as ABC complicated with MAS, and he underwent surgery. OUTCOMES After the surgery, his sight became normal. Recurrence of ABC and visual disturbance was not observed in 3 years. Genetic analysis of a tissue sample from the ABC lesion by next-generation sequencing revealed a somatic activating GNAS mutation. LESSONS To the best of our knowledge, this is the first case report of MAS causing optic neuropathy complicated with ABC. ABC complicated with MAS is extremely rare, but it should be considered as a possible diagnosis in patients with acute visual loss and facial swelling. In addition, our case had OAS, which is an uncommon syndrome and a rare complication in ABC with MAS, and rapid decompression of the ABC was effective in improving the patient's eyesight.
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Affiliation(s)
- Hiroshi Ninomiya
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Michio Ozeki
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Akifumi Nozawa
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
- Department of Medical Genetics, Tohoku University School of Medicine, Sendai, Japan
| | - Shiho Yasue
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Saori Endo
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Masayuki Inuzuka
- Department of Ophthalmology, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Natsuko Obara
- Department of Otorhinolaryngology, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Kiyofumi Mochizuki
- Department of Ophthalmology, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Masaya Kawaguchi
- Department of Radiology, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Yo Kaneko
- Department of Radiology, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Yoko Aoki
- Department of Medical Genetics, Tohoku University School of Medicine, Sendai, Japan
| | - Masayuki Matsuo
- Department of Radiology, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Yanagido, Gifu, Gifu, Japan
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9
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Yano H, Miwa K, Nakayama N, Maruyama T, Ohe N, Ikuta S, Ikegame Y, Owashi E, Ohmura K, Yokoyama K, Kumagai M, Muragaki Y, Iwama T, Shinoda J. NI-6 Preoperative differential diagnosis of grade II and grade III in cases with astrocytoma, IDH mutant. Neurooncol Adv 2021. [PMCID: PMC8648256 DOI: 10.1093/noajnl/vdab159.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose: We attempted to differentiate between IDH-mutant astrocytoma Grade II and grade III by using methionine (MET) positron emission tomography (PET) and magnetic resonance spectroscopy (MRS). Subjects and Methods: We retrospectively analyzed 41 adult supratentorial glioma cases with confirmed histological diagnosis and IDH status from June 2015 to June 2020. These included 21 males, with an average age of 38.5 years (19–59 years), including seven astrocytoma grade II (A-II) and 34 grade III (A-III) cases. We determined the accumulation value rate of the maximum tumor to normal cortex accumulation value (T/N ratio) in MET-PET. We obtained the peak ratios of N-acetyl aspartate (NAA)/ creatine (Cr), choline (Cho)/Cr, and Cho/NAA. We investigated the correlation between the T/N ratios and MRS parameters and examined the contrast effects on MRI. Results: There were no significant differences in the T/N ratio and MRS parameters between A-IIs and A-IIIs. Only Cho/NAA ratios were significantly correlated with the T/N ratios (r = 0.443, P = 0.0037). We divided the distribution map into four areas with the highest T/N ratio of AII (1.59) and the highest Cho/NAA ratio (3.66). That is, 1) T/N ratio ≤ 1.59 & Cho/NAA ≤ 3.66, 2) >1.59 & ≤ 3.66, 3) ≤1.59 & > 3.66, 4) > 1.59 & > 3.66. The diagnostic rates for A-III were 1) 61.1% (11/18), 2) 100% (7/7), 3) 100% (9/9), and 4) 100% (7/7). We found the contrast effects in only 7 cases (20.6%) of A-III, which were distributed in areas 2) to 4). Conclusion: A-IIs and A-IIIs distributed in area 1) were difficult to distinguish, and they need careful observation as a step before the transition to areas 2)-4). Meanwhile, A-IIIs reaching widespread distribution to areas 2)-4) because of their wide range of malignancies require clinically aggressive treatment. The method might be beneficial in grade analysis of IDH-mutant astrocytomas.
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Affiliation(s)
- Hirohito Yano
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, MInokamo, Gifu, Japan
| | - Kazuhiro Miwa
- Department of Neurosurgery, Kizawa Memorial Hospital
| | - Noriyuki Nakayama
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | | | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Souko Ikuta
- Department of Neurosurgery, Tokyo Women’s Medical University
| | - Yuka Ikegame
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, MInokamo, Gifu, Japan
| | - Etsuko Owashi
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, MInokamo, Gifu, Japan
| | - Kazufumi Ohmura
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, MInokamo, Gifu, Japan
| | | | - Morio Kumagai
- Department of Neurosurgery, Kizawa Memorial Hospital
| | | | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Jun Shinoda
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, MInokamo, Gifu, Japan
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10
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Shoda K, Ohe N, Sasai H, Miyai M, Ohnishi H, Iwama T. Endoscopic third ventriculostomy for hydrocephalus in a patient with achondroplasia: a case report and literature review. Childs Nerv Syst 2021; 37:3907-3911. [PMID: 33779806 DOI: 10.1007/s00381-021-05129-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
Hydrocephalus, a complication of achondroplasia, requires treatment when it is symptomatic. Hydrocephalus associated with achondroplasia is often treated with ventriculoperitoneal shunting, and endoscopic third ventriculostomy (ETV) is rarely performed in these patients. Here, we report the case of an 18-month-old boy with achondroplasia and progressive hydrocephalus who underwent ETV. He had a family history of achondroplasia and was diagnosed with achondroplasia at birth. Magnetic resonance imaging (MRI) at the age of 1 month showed no hydrocephalus. At the age of 15 months, he was admitted to our hospital due to increased head circumference. He had developmental delays, and MRI showed hydrocephalus with ballooning of the third ventricle. The ETV success score was 80 points; therefore, we performed ETV. Postoperatively, the progression of head circumference increase was controlled. The ventricular size remained unchanged on MRI at 13 months after surgery. Recently, an association between non-communicating hydrocephalus and achondroplasia has been reported. Depending on age and imaging findings, ETV may be effective in some patients with achondroplasia with hydrocephalus.
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Affiliation(s)
- Kenji Shoda
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan.
| | - Naoyuki Ohe
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan
| | - Hideo Sasai
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Masafumi Miyai
- Department of Neurosurgery, Ogaki Tokusyukai Hospital, Gifu, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan
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11
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Imai N, Ohe N, Ozeki M, Endo S, Yasue S, Iwama T. A Sporadic Pediatric Case of Huge Intracranial Supratentorial Desmoid-type Fibromatosis. NMC Case Rep J 2021; 8:63-67. [PMID: 34012751 PMCID: PMC8116928 DOI: 10.2176/nmccrj.cr.2020-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/11/2020] [Indexed: 12/03/2022] Open
Abstract
Desmoid-type fibromatosis (DTF) is a rare locally aggressive soft tissue neoplasm without metastatic potential. Here, we report a very rare sporadic case of an intracranial supratentorial extradural DTF measuring 82 mm in a 1-year-old girl, that recurred twice following surgery over the course of 16 months, requiring two other surgeries. In three surgeries, we resected a huge tumor with the dura which was thought to be tumor origin and removed this tumor infiltrated the frontal skull base by drilling widely. Furthermore, we treated the tumor invading the bone flap using liquid nitrogen for 20 minutes, and subsequently used it to perform a cranioplasty. This tumor has not recurred for past 8 months. DTF invading the skull base is prone to recurrence, and liquid nitrogen treatment is considered to be effective in pediatric patients, who need cranioplasty with tumor-infiltrating autologous bone flaps.
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Affiliation(s)
- Naoya Imai
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Gifu, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Gifu, Japan
| | - Michio Ozeki
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Gifu, Japan
| | - Saori Endo
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Gifu, Japan
| | - Shiho Yasue
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Gifu, Japan
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12
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Takao K, Tani A, Suwa T, Kuwabara-Ohmura Y, Nonomura K, Liu Y, Kato T, Mizuno M, Hirota T, Enya M, Iizuka K, Horikawa Y, Saigo C, Kito Y, Miyazaki T, Ohe N, Iwama T, Yabe D. Diagnosis and treatment of primary central nervous system lymphoma with the primary lesion in the hypothalamus: a case report. BMC Endocr Disord 2021; 21:13. [PMID: 33430828 PMCID: PMC7802214 DOI: 10.1186/s12902-020-00675-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/26/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Primary central nervous system lymphoma is a rare extra-nodal lymphoma of the central nervous system. Primary central nervous system lymphoma lesions usually appear in the vicinity of the ventricle, and there are few reports of primary central nervous system lymphoma with hypothalamic-pituitary lesions. CASE PRESENTATION We treated a 56-year-old male with primary central nervous system lymphoma with the primary lesion in the hypothalamus, which was found by magnetic resonance imaging after sudden onset of endocrinological abnormalities. Initially, he was hospitalized to our department for hyponatremia. Endocrinological examination in conjunction with head magnetic resonance imaging and endoscopic biopsy revealed hypothalamic hypopituitarism and tertiary hypoadrenocorticism caused by a rapidly growing, diffuse large B-cell lymphoma in the hypothalamus. Remission of the tumor was achieved by high-dose methotrexate with whole brain radiotherapy, and some of the hormone responses were normalized. CONCLUSIONS While primary central nervous system lymphoma is rare, it is important to note that hypopituitarism can result and that the endocrinological abnormalities can be partially restored by its remission.
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Affiliation(s)
- Ken Takao
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Ayaka Tani
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Tetsuya Suwa
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Yayoi Kuwabara-Ohmura
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Kenta Nonomura
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yanyan Liu
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Takehiro Kato
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Masami Mizuno
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Takuo Hirota
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Mayumi Enya
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Katsumi Iizuka
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yukio Horikawa
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Chiemi Saigo
- Division of Pathology, Gifu University Hospital, Gifu, Japan
| | - Yusuke Kito
- Division of Pathology, Gifu University Hospital, Gifu, Japan
| | | | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daisuke Yabe
- Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
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13
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Ono Y, Yoshikura N, Takekoshi A, Ohe N, Hayashi H, Yamada M, Hayashi Y, Kimura A, Shimohata T. Brain Abscess Presenting as Prolonged Headache in a Patient with Amyotrophic Lateral Sclerosis under Mechanical Ventilation. Intern Med 2020; 59:581-583. [PMID: 31611533 PMCID: PMC7056388 DOI: 10.2169/internalmedicine.3709-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 57-year-old woman with amyotrophic lateral sclerosis (ALS) receiving mechanical ventilation developed intractable right temporal headache. She was diagnosed with brain abscess secondary to chronic suppurative otitis media. In this case, the otitis media was caused by nasopharyngeal reflux associated with eustachian tube muscle weakness and a supine position. In addition, ALS patients under mechanical ventilation have a limited ability to convey their pain. Their complaints are often overlooked because many physicians do not know that pain is common in ALS. Physicians should recognize brain abscess as a severe complication of ALS and listen to the complaints of these patients.
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Affiliation(s)
- Yoya Ono
- Department of Neurology, Gifu University Graduate School of Medicine, Japan
| | - Nobuaki Yoshikura
- Department of Neurology, Gifu University Graduate School of Medicine, Japan
| | - Akira Takekoshi
- Department of Neurology, Gifu University Graduate School of Medicine, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Japan
| | - Hisamitsu Hayashi
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Japan
| | - Megumi Yamada
- Department of Neurology, Gifu University Graduate School of Medicine, Japan
| | - Yuichi Hayashi
- Department of Neurology, Gifu University Graduate School of Medicine, Japan
| | - Akio Kimura
- Department of Neurology, Gifu University Graduate School of Medicine, Japan
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14
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Yano H, Nakayama N, Ohe N, Miyai M, Yamada T, Miwa K, Shinoda J, Iwama T. NI-05 CLINICOPATHOLOGICAL ANALYSIS AND METHIONINE PET ANALYSIS IN PATIENTS WITH GLIOMATOSIS CEREBRI. Neurooncol Adv 2019. [PMCID: PMC7213396 DOI: 10.1093/noajnl/vdz039.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Gliomatosis cerebri (GC) was defined as the tumor infiltrating into more than three lobes in WHO2007, but was deleted in WHO2016 because they include genetically heterogeneous tissues. However, we often encounter the cases with strongly invasive glioma. Then, we clinically analyzed the cases of GC. PATIENTS AND METHODS Seven cases (five men, median age: 57 years (23-89y)) diagnosed as GC in our hospital were included. Data of methionine-positron emission tomography (Met-PET), IDH and p53 mutation, MIB1-labeling index (LI) by immunohistochemistry were searched. We compared the accumulation areas of the Met-PET with the hyperintensity area (T2/FLAIR-high) and gadolinium-enhanced area on the MRI. We also examined a biopsy method, sites and a treatment regimen and analyzed overall survival (OS) and progression-free survival (PFS). RESULTS The primary symptoms were disorientation in five, epileptic seizure and abnormal vision were two, respectively. The largest lesion area with the image was T2/FLAIR-high, followed by Met-PET and Gd in all. The surgical methods were stereotactic biopsy (2), navigation-guided biopsy (2), endoscopic biopsy (1), and craniotomy (2), The average of tumor/normal ratio in Met-PET was 2.92 (1.97–5.0). The pathological grade was diagnosed as Grade III in 4 and Grade II in 3. IDH1R132H was negative in all, p53 was positive in 5, and an average of MIB-1LI was 12% (2–35). The radiotherapy was performed in 6 cases, and, temozolomide was given to all, and bevacizumab was in 3. Six patients died of a tumor. Median PFS and OS were 8mos and 16.5mos, respectively. CONCLUSION Because the GC cannot expect improvement by surgery, it is necessary to obtain the pathological diagnosis by a quick and correct biopsy, and the neurologic deterioration by the biopsy technique should be avoided. The Met-PET suggesting the highest grade site was useful for the plan of the biopsy site.
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Noriyuki Nakayama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masafumi Miyai
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tetsuya Yamada
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiro Miwa
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Jun Shinoda
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
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15
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Abstract
Gorham-Stout disease (GSD) is a rare condition in which spontaneous, progressive resorption of bone occurs. There are no previous reports of patients with fatal progression of GSD with skull base osteomyelitis (SBO) and lateral medullary syndrome (LMS). We present the case of a 27-year-old man diagnosed with GSD with involvement of the maxillofacial bones and skull base. The patient developed SBO; LMS resulted from progressive osteolysis, and the patient died of associated brainstem stroke. Careful follow-up with special emphasis on the early detection of intracranial complications is critical in patients presenting with progressive GSD with involvement of the skull base.
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Affiliation(s)
- Akifumi Nozawa
- Department of Pediatrics, Gifu University Graduate School of Medicine, Japan
| | - Michio Ozeki
- Department of Pediatrics, Gifu University Graduate School of Medicine, Japan
| | - Tomohiro Hori
- Department of Pediatrics, Gifu University Graduate School of Medicine, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University Graduate School of Medicine, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Japan
| | - Toshiyuki Fukao
- Department of Pediatrics, Gifu University Graduate School of Medicine, Japan
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16
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Takekoshi A, Yoshikura N, Ozawa K, Ikoma Y, Kitagawa J, Takeshima A, Otsuki M, Nakamichi K, Saijo M, Ohe N, Mochizuki K, Kakita A, Shimohata T. [A Patient with Progressive Multifocal Leukoencephalopathy Who Developed Bálint Syndrome Improved by Combination Therapy Using Mefloquine and Mirtazapine]. Brain Nerve 2019; 71:281-286. [PMID: 30827961 DOI: 10.11477/mf.1416201256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We describe a 62-year-old man who developed subacute visual loss after cord blood stem cell transplantation for malignant lymphoma. Brain magnetic resonance imaging (MRI) showed bilateral hyperintense lesions in the occipital and parietal lobes. A diagnosis of progressive multifocal encephalopathy (PML) was established following brain biopsy and detection of JC virus (JCV) deoxyribonucleic acid (DNA) in the cerebrospinal fluid (CSF). He developed optic ataxia and visual inattention, and was then diagnosed as having Bálint syndrome. After he was treated with mefloquine and mirtazapine, his Bálint syndrome and, MRI findings improved and the copy number of JCV DNA in the CSF decreased. In summary, we demonstrate that patient with PML may develop Bálint syndrome and that combination therapy using mefloquine and mirtazapine may be an effective treatment. (Received August 23, 2018; Accepted November 29, 2018; Published March 1, 2019).
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Affiliation(s)
- Akira Takekoshi
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine
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17
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Nakayama N, Yano H, Egashira Y, Enomoto Y, Ohe N, Kanemura N, Kitagawa J, Iwama T. Efficacy, Reliability, and Safety of Completely Autologous Fibrin Glue in Neurosurgical Procedures: Single-Center Retrospective Large-Number Case Study. World Neurosurg 2017; 109:e819-e828. [PMID: 29107157 DOI: 10.1016/j.wneu.2017.10.097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/15/2017] [Accepted: 10/17/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Commercially available fibrin glue (Com-FG), which is used commonly worldwide, is produced with pooled human plasma from multiple donors. However, it has added bovine aprotinin, which involves the risk of infection, allogenic immunity, and allergic reactions. We evaluate the efficacy, reliability, and safety of completely autologous fibrin glue (CAFG). METHODS From August 2014 to February 2016, prospective data were collected and analyzed from 153 patients. CAFG was prepared with the CryoSeal System using autologous blood and was applied during neurosurgical procedures. Using CAFG-soaked oxidized regenerated cellulose and/or polyglycolic acid sheets, we performed a pinpoint hemostasis, transposed the offending vessels in a microvascular decompression, and covered the dural incision to prevent cerebrospinal fluid leakage. RESULTS The CryoSeal System had generated up to a mean of 4.51 mL (range, 3.0-8.4 mL) of CAFG from 400 mL autologous blood. Com-FG products were not used in our procedures. Only 6 patients required an additional allogeneic blood transfusion. The hemostatic effective rate was 96.1% (147 of 153 patients). Only 1 patient who received transsphenoidal surgery for a pituitary adenoma presented with the complication of delayed postoperative cerebrospinal fluid leakage (0.65%). No patient developed allergic reactions or systemic complications associated with the use of CAFG. CONCLUSIONS CAFG effectively provides hemostatic, adhesive, and safety performance. The timing and three-dimensional shape of CAFG-soaked oxidized regenerated cellulose and/or polyglycolic acid sheets solidification can be controlled with slow fibrin formation. The cost to prepare CAFG is similar compared with Com-FG products, and it can therefore be easily used at most institutions.
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Affiliation(s)
- Noriyuki Nakayama
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan.
| | - Hirohito Yano
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Yusuke Egashira
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Yukiko Enomoto
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan
| | | | - Junichi Kitagawa
- Department of Transfusion Medicine, Gifu University, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan
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18
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Yano H, Nakayama N, Ohe N, Miwa K, Shinoda J, Iwama T. Pathological analysis of the surgical margins of resected glioblastomas excised using photodynamic visualization with both 5-aminolevulinic acid and fluorescein sodium. J Neurooncol 2017; 133:389-397. [DOI: 10.1007/s11060-017-2445-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
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19
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Ohe N, Iwama T. [Bevacizumab]. Nihon Rinsho 2016; 74 Suppl 7:646-649. [PMID: 30634827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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20
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Ohe N, Tsujimoto M, Owashi E, Nakayama N, Yano H, Iwama T. LG-18TWO CASES REPORT OF INFANTILE PILOMYXOID ASTROCYTOMA. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now075.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Yano H, Nakayama N, Morimitsu K, Futamura M, Ohe N, Miwa K, Shinoda J, Iwama T. Changes in protein level in the cerebrospinal fluid of a patient with cerebral radiation necrosis treated with bevacizumab. Clin Med Insights Oncol 2014; 8:153-7. [PMID: 25574147 PMCID: PMC4263439 DOI: 10.4137/cmo.s19823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/28/2014] [Accepted: 10/30/2014] [Indexed: 11/05/2022]
Abstract
A 32-year-old woman underwent surgeries and radiation therapy for astrocytoma. She developed symptomatic radiation necrosis in the lesion, which caused hydrocephalus. She initially underwent ventricular drainage, because the protein level in the cerebrospinal fluid (CSF) was 787 mg/dL, which was too high for shunt surgery. Because she also had breast cancer, which was pathologically diagnosed as an invasive ductal carcinoma, standard bevacizumab therapy in combination with paclitaxel every 2 weeks was selected. Interestingly, after 2 days, the agents had dramatically reduced the CSF protein level. However, it returned to approximately the initial level within 2 weeks. After two courses of this regimen, a ventriculoperitoneal shunt was placed. After 10 courses of this regimen, the CSF protein level decreased to 338 mg/dL, which is less than half of the initial level. Long-term administration of bevacizumab might decrease leakage of protein from the vessels around the ventriculus.
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Noriyuki Nakayama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kasumi Morimitsu
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Manabu Futamura
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiro Miwa
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Japan
| | - Jun Shinoda
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
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Hoffman LM, Donson AM, Nakachi I, Griesinger AM, Birks DK, Amani V, Hemenway MS, Liu AK, Wang M, Hankinson TC, Handler MH, Foreman NK, Zakrzewska M, Zakrzewski K, Fendler W, Stefanczyk L, Liberski PP, Massimino M, Gandola L, Ferroli P, Valentini L, Biassoni V, Garre ML, Sardi I, Genitori L, Giussani C, Massimi L, Bertin D, Mussano A, Viscardi E, Modena P, Mastronuzzi A, Barra S, Scarzello G, Cinalli G, Peretta P, Giangaspero F, Massimino M, Boschetti L, Biassoni V, Garre ML, Schiavello E, Sardi I, Genitori L, Bertin D, Modena P, Calareso G, Barra S, Scarzello G, Cinalli G, Peretta P, Mastronuzzi A, Giussani C, Giangaspero F, Antonelli M, Pecori E, Gandola L, Massimino M, Biassoni V, Di Meco F, Garre ML, Schiavello E, Sardi I, Genitori L, Bertin D, Viscardi E, Modena P, Barra S, Scarzello G, Cinalli G, Peretta P, Migliorati R, Taborelli A, Giangaspero F, Antonelli M, Pecori E, Gandola L, Witt H, Sill M, Wani K, Mack SC, Capper D, Pajtler K, Lambert S, Tzaridis T, Milde T, Northcott PA, Kulozik AE, Witt O, Collins VP, Ellison DW, Taylor MD, Kool M, Jones DTW, Korshunov A, Ken A, Pfister SM, Makino K, Nakamura H, Kuroda JI, Kuratsu JI, Toledano H, Margolin Y, Ohali A, Michowiz S, Witt H, Johann P, Tzaridis T, Tabori U, Walker E, Hawkins C, Taylor M, Yaniv I, Avigad S, Hoffman L, Plimpton SR, Foreman NK, Stence NV, Hankinson TC, Handler MH, Hemenway MS, Vibhakar R, Liu AK, Lourdusamy A, Rahman R, Ward J, Rogers H, Grundy R, Punchihewa C, Lee R, Lin T, Orisme W, Dalton J, Aronica E, Smith A, Gajjar A, Onar A, Pounds S, Tatevossian R, Merchant T, Ellison D, Parker M, Mohankumar K, Punchihewa C, Weinlich R, Dalton J, Tatevossian R, Phoenix T, Thiruvenkatam R, White E, Gupta K, Gajjar A, Merchant T, Boop F, Smith A, Ding L, Mardis E, Wilson R, Downing J, Ellison D, Gilbertson R, Ward J, Lourdusamy A, Speed D, Gould T, Grundy R, Rahman R, Mack SC, Witt H, Pfister SM, Korshunov A, Taylor MD, Consortium TIE, Hoffman LM, Griesinger A, Donson A, Birks D, Amani V, Foreman NK, Ohe N, Yano H, Nakayama N, Iwama T, Wright K, Hassall T, Bowers DC, Crawford J, Bendel A, Fisher PG, Merchant T, Ellison D, Klimo P, Boop F, Armstrong G, Qaddoumi I, Robinson G, Wetmore C, Broniscer A, Gajjar A, Rogers H, Chapman R, Mayne C, Duane H, Kilday JP, Coyle B, Grundy R, Graul-Conroy A, Hartsell W, Bragg T, Goldman S, Rebsamen S, Puccetti D, Salamat S, Patel NJ, Gomi A, Oguma H, Hayase T, Kawahara Y, Yagi M, Morimoto A, Wilbur C, Dunham C, Hawkins C, Tabori U, Mabbott D, Carret AS, Lafay-Cousin L, McNeely PD, Eisenstat D, Wilson B, Johnston D, Hukin J, Mynarek M, Kortmann RD, Kaatsch P, Pietsch T, Timmermann B, Fleischhack G, Benesch M, Friedrich C, von Bueren AO, Gerber NU, Muller K, Tippelt S, Warmuth-Metz M, Rutkowski S, von Hoff K, Murugesan MK, White E, Poppleton H, Thiruvenkatam R, Gupta K, Currle S, Kranenburg T, Eden C, Wright K, Ellison D, Gilbertson R, Boulos N, Dapper J, Patel Y, Wright K, Mohankumar K, Freeman B, Gajjar A, Shelat A, Stewart C, Guy R, Gilbertson R, Adamski J, Taylor M, Tabori U, Huang A, Bartels U, Ramaswamy V, Krishnatry R, Laperriere N, Hawkins C, Bouffet E, Araki A, Chocholous M, Gojo J, Dorfer C, Czech T, Dieckmann K, Slavc I, Haberler C, Pietsch T, Mynarek M, Doerner E, Muehlen AZ, Warmuth-Metz M, Kortmann R, von Buehren A, Friedrich C, von Hoff K, Rutkowski S, von Hoff K, Kortmann RD, Gerber NU, Mynarek M, Muller K, Friedrich C, von Bueren AO, Benesch M, Warmuth-Metz M, Ottensmeier H, Resch A, Kwiecien R, Faldum A, Kuehl J, Pietsch T, Rutkowski S, Sabnis D, Storer L, Simmonds L, Blackburn S, Lowe J, Grundy R, Kerr I, Coyle B, Pietsch T, Wohlers I, Goschzik T, Dreschmann V, Denkhaus D, Doerner E, Rahmann S, Klein-Hitpass L, Iglesias MJL, Riet FG, Dhermain FD, Canale S, Dufour C, Rose CS, Puget S, Grill J, Bolle S, Parkes J, Davidson A, Figaji A, Pillay K, Kilborn T, Padayachy L, Hendricks M, Van Eyssen A, Piccinin E, Lorenzetto E, Brenca M, Massimino M, Modena P, Taylor M, Ramaswamy V, Bouffet E, Aldape K, Cho YJ, Weiss W, Phillips J, Jabado N, Mora J, Fan X, Jung S, Lee JY, Zitterbart K, French P, Kros JM, Hauser P, Faria C, Korshunov A, Pfister S, Mack SC. EPENDYMOMA. Neuro Oncol 2014; 16:i17-i25. [PMCID: PMC4046284 DOI: 10.1093/neuonc/nou068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
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Bertozzi AI, Munzer C, Fouyssac F, Andre N, Boetto S, Leblond P, Bourdeaut F, Dufour C, Deshpande RK, Bhat KG, Mahalingam S, Muscat A, Cain J, Ferguson M, Popovski D, Algar E, Rossello FJ, Jayasekara S, Watkins DN, Hodge J, Ashley D, Hishii M, Saito M, Arai H, Han ZY, Richer W, Lucchesi C, Freneaux P, Nicolas A, Grison C, Pierron G, Delattre O, Bourdeaut F, Epari S, TS N, Gupta T, Chinnaswamy G, Sastri JG, Shetty P, Moiyadi A, Jalali R, Fay-McClymont T, Johnston D, Janzen L, Guger S, Scheinemann K, Fleming A, Fryer C, Hukin J, Mabbott D, Huang A, Bouffet E, Lafay-Cousin L, Kawamura A, Yamamoto K, Nagashima T, Bartelheim K, Benesch M, Buchner J, Gerss J, Hasselblatt M, Kortmann RD, Fleischack G, Quiroga E, Reinhard H, Schneppenheim R, Seeringer A, Siebert R, Timmermann B, Warmuth-Metz M, Schmid I, Fruhwald MC, Fruhwald MC, Bartelheim K, Seeringer A, Kerl K, Kortmann RD, Warmuth-Metz M, Hasselblatt M, Schneppenheim R, Siebert R, Klingebiel T, Al-Kofide A, Khafaga Y, Al-Hindi H, Dababo M, Ul-Haq A, Anas M, Barria MG, Siddiqui K, Hassounah M, Ayas M, Al-Shail E, Hasselblatt M, Jeibmann A, Eikmeier K, Linge A, Johann P, Koos B, Bartelheim K, Kool M, Pfister SM, Fruhwald MC, Paulus W, Hasselblatt M, Schuller U, Junckerstorff R, Rosenblum MK, Alassiri AH, Rossi S, Bartelheim K, Schmid I, Gottardo N, Toledano H, Viscardi E, Witkowski L, Nagel I, Oyen F, Foulkes WD, Paulus W, Siebert R, Schneppenheim R, Fruhwald MC, Schrey D, Malietzis G, Chi S, Dufour C, Lafay-Cousin L, Marshall L, Carceller F, Moreno L, Zacharoulis S, Bhardwaj R, Chakravadhanula M, Ozals V, Hampton C, Metpally R, Grillner P, Asmundsson J, Gustavsson B, Holm S, Johann PD, Korshunov A, Ryzhova M, Kerl K, Milde T, Witt O, Jones DTW, Hovestadt V, Gajjar A, Hasselblatt M, Fruhwald M, Pfister S, Kool M, Finetti M, Pons ADC, Selby M, Smith A, Crosier S, Wood J, Skalkoyannis B, Bailey S, Clifford S, Williamson D, Seeringer A, Bartelheim K, Kerl K, Hasselblatt M, Rutkowski S, Timmermann B, Kortmann RD, Schneppenheim R, Warmuth-Metz M, Gerss J, Siebert R, Graf N, Boos J, Nysom K, Fruhwald MC, Kerl K, Moreno N, Holsten T, Ahlfeld J, Mertins J, Hotfilder M, Kool M, Bartelheim K, Schleicher S, Handgretinger R, Fruhwald M, Meisterernst M, Kerl K, Schmidt C, Ahlfeld J, Moreno N, Dittmar S, Pfister S, Fruhwald M, Kool M, Meisterernst M, Schuller U, Chan GCF, Shing MMK, Yuen HL, Li RCH, Ling SL, Slavc I, Peyrl A, Chocholous M, Azizi A, Czech T, Dieckmann K, Haberler C, Leiss U, Gotti G, Biassoni V, Schiavello E, Spreafico F, Pecori E, Gandola L, Massimino M, Mertins J, Kornelius K, Moreno N, Holsten T, Fruhwald M, Kool M, Meisterernst M, Yano H, Nakayama N, Ohe N, Ozeki M, Kanda K, Kimura T, Hori T, Fukao T, Iwama T, Weil AG, Diaz A, Gernsback J, Bhatia S, Ragheb J, Niazi T, Khatib Z, Kerl K, Holsten T, Moreno N, Zoghbi A, Meisterernst AM, Birks D, Griesinger A, Amani V, Donson A, Posner R, Dunham C, Kleinschmidt-DeMasters BK, Handler M, Vibhakar R, Foreman N, Bhardwaj R, Ozals V, Hampton C, Zhou L, Catchpoole D, Chakravadhanula M, Kakkar A, Biswas A, Suri V, Sharma M, Kale S, Mahapatra A, Sarkar C, Torchia J, Picard D, Ho KC, Khuong-Quang DA, Louterneau L, Bourgey M, Chan T, Golbourn B, Cousin LL, Taylor MD, Dirks P, Rutka JT, Bouffet E, Hawkins C, Majewski J, Kim SK, Jabado N, Huang A, Chang JHC, Confer M, Chang A, Goldman S, Dunn M, Hartsell W. ATYPICAL TERATOID RHABDOID TUMOUR. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ohtakara K, Ohe N, Iwama T, Hoshi H. Early manifestation of communicating hydrocephalus after fractionated stereotactic radiotherapy for aggressive giant atypical prolactinoma. Anticancer Res 2014; 34:2509-2515. [PMID: 24778068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Aggressive giant invasive pituitary adenomas refractory to standard surgical or medical treatment remain a genuine challenge. In addition, communicating hydrocephalus (CH) attributed to malabsorption of cerebrospinal fluid (CSF) developing after radiotherapy for pituitary adenomas has not been previously reported. Herein, we describe the case of a 48-year-old male presenting with a giant atypical prolactinoma refractory to previous therapies, including pharmacotherapy and repetitive surgery. He underwent image-guided fractionated stereotactic radiotherapy in 28 fractions, resulting in early manifestation of CH associated with undisputed, both radiological and hormonal response. He recovered well after a shunt placement, with otherwise favorable consequences such as sustained tumor regression, decreasing prolactin level, and retained visual function for a 22-month follow-up. Fractionated stereotactic radiotherapy would provide a viable treatment alternative for these refractory cases, while caution should be exercised regarding the possibility of iatrogenic CH.
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Affiliation(s)
- Kazuhiro Ohtakara
- Department of Radiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
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Yano H, Saigoh C, Nakayama N, Hirose Y, Abe M, Ohe N, Ozeki M, Shinoda J, Iwama T. Mixed neuronal-glial tumor in the temporal lobe of an infant: a case report. Diagn Pathol 2013; 8:164. [PMID: 24088576 PMCID: PMC3853443 DOI: 10.1186/1746-1596-8-164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 09/15/2013] [Indexed: 11/10/2022] Open
Abstract
Background Tumors that arise in the temporal lobes of infants and spread to the neural system are limited to several diagnoses. Herein, we present an infantile case of a temporal tumor showing neuronal and glial differentiation. Case presentation The patient was a 9-month-old boy with low body weight due to intrauterine growth retardation. At 9 months after birth, he presented partial seizures. Computed tomography scanning revealed a mass (35 * 40 mm) in the left temporal lobe. Isointensity was noted on magnetic resonance T1-weighted images and fluid attenuation inversion recovery images. The tumor was heterogeneously enhanced with gadolinium. Positron emission tomography showed high methionine uptake in the tumor. During surgery, the tumor, which was elastic and soft and bled easily, was gross totally resected. A moderately clear boundary was noted between the tumor and normal brain parenchyma. Histologically, the tumor mainly comprised a ganglioglioma-like portion and short spindle cells at different densities. The former was immunohistochemically positive for some kinds of neuronal markers including synaptophysin. The spindle cells were positive for glial fibrillary acidic protein, but desmoplasia was not observed. Discussion The tumor contained both neuronal and glial elements; the former were the main constituents of the tumor and included several ganglion-like cells. Because neuronal elements gradually transited to glial cells, a mixed neuronal-glial tumor was diagnosed. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2045126100982604
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.
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Li KKW, Pang JCS, Ng HK, Massimino M, Gandola L, Biassoni V, Spreafico F, Schiavello E, Poggi G, Casanova M, Pecori E, De Pava MV, Ferrari A, Meazza C, Terenziani M, Polastri D, Luksch R, Podda M, Modena P, Antonelli M, Giangaspero F, Ahmed S, Zaghloul MS, Mousa AG, Eldebawy E, Elbeltagy M, Awaad M, Massimino M, Gandola L, Biassoni V, Antonelli M, Schiavello E, Buttarelli F, Spreafico F, Collini P, Pollo B, Patriarca C, Giangaspero F, MacDonald T, Liu J, Munson J, Park J, Wang K, Fei B, Bellamkonda R, Arbiser J, Gomi A, Yamaguchi T, Mashiko T, Oguro K, Somasundaram A, Neuberg R, Grant G, Fuchs H, Driscoll T, Becher O, McLendon R, Cummings T, Gururangan S, Bourdeaut F, Grison C, Doz F, Pierron G, Delattre O, Couturier J, Cho YJ, Pugh T, Weeraratne SD, Archer T, Krummel DP, Auclair D, Cibulkis K, Lawrence M, Greulich H, McKenna A, Ramos A, Shefler E, Sivachenko A, Amani V, Pierre-Francois J, Teider N, Northcott P, Taylor M, Meyerson M, Pomeroy S, Potts C, Cline H, Rotenberry R, Guldal C, Bhatia B, Nahle Z, Kenney A, Fan YN, Pizer B, See V, Makino K, Nakamura H, Kuratsu JI, Grahlert J, Ma M, Fiaschetti G, Shalaby T, Grotzer M, Baumgartner M, Clifford S, Gustafsson G, Ellison D, Figarella-Branger D, Doz F, Rutkowski S, Lannering B, Pietsch T, Fiaschetti G, Shalaby T, Baumgartner M, Grotzer M, Fleischhack G, Siegler N, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Yoon JH, Kang HJ, Park KD, Park SH, Phi JH, Kim SK, Wang KC, Kim IH, Shin HY, Ahn HS, Faria C, Golbourn B, Smith C, Rutka J, Greene BD, Whitton A, Singh S, Scheinemann K, Hill R, Lindsey J, Howell C, Ryan S, Shiels K, Shrimpton E, Bailey S, Clifford S, Schwalbe E, Lindsey J, Williamson D, Hamilton D, Northcott P, O'Toole K, Nicholson SL, Lusher M, Gilbertson R, Hauser P, Taylor M, Taylor R, Ellison D, Bailey S, Clifford S, Kool M, Jones DTW, Jager N, Hovestadt V, Schuller U, Jabado N, Perry A, Cowdrey C, Croul S, Collins VP, Cho YJ, Pomeroy S, Eils R, Korshunov A, Lichter P, Pfister S, Northcott P, Shih D, Taylor M, Darabi A, Sanden E, Visse E, Siesjo P, Harris P, Venkataraman S, Alimova I, Birks D, Cristiano B, Donson A, Foreman N, Vibhakar R, Bertin D, Vallero S, Basso ME, Romano E, Peretta P, Morra I, Mussano A, Fagioli F, Kunkele A, De Preter K, Heukamp L, Thor T, Pajtler K, Hartmann W, Mittelbronn M, Grotzer M, Deubzer H, Speleman F, Schramm A, Eggert A, Schulte J, Bandopadhayay P, Kieran M, Manley P, Robison N, Chi S, Thor T, Mestdagh P, Vandesomple J, Fuchs H, Durner VG, de Angelis MH, Heukamp L, Kunkele A, Pajtler K, Eggert A, Schramm A, Schulte JH, Ohe N, Yano H, Nakayama N, Iwama T, Lastowska M, Perek-Polnik M, Grajkowska W, Malczyk K, Cukrowska B, Dembowska-Baginska B, Perek D, Othman RT, Storer L, Grundy R, Kerr I, Coyle B, Hulleman E, Lagerweij T, Biesmans D, Crommentuijn MHW, Cloos J, Tannous BA, Vandertop WP, Noske DP, Kaspers GJL, Wurdinger T, Bergthold G, El Kababri M, Varlet P, Dhermain F, Sainte-Rose C, Raquin MA, Valteau-Couanet D, Grill J, Dufour C, Burchill C, Hii H, Dallas P, Cole C, Endersby R, Gottardo N, Gevorgian A, Morozova E, Kazantsev I, Youhta T, Safonova S, Kozlov A, Punanov Y, Afanasyev B, Zheludkova O, Packer R, Gajjar A, Michalski J, Jakacki R, Gottardo N, Tarbell N, Vezina G, Olson J, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Malbari F, Atlas M, Friedman G, Kelly V, Bray A, Cassady K, Markert J, Gillespie Y, Taylor R, Howman A, Brogden E, Robinson K, Jones D, Gibson M, Bujkiewicz S, Mitra D, Saran F, Michalski A, Pizer B, Jones DTW, Jager N, Kool M, Zichner T, Hutter B, Sultan M, Cho YJ, Pugh TJ, Warnatz HJ, Reifenberger G, Northcott PA, Taylor MD, Meyerson M, Pomeroy SL, Yaspo ML, Korbel JO, Korshunov A, Eils R, Pfister SM, Lichter P, Pajtler KW, Weingarten C, Thor T, Kuenkele A, Fleischhack G, Heukamp LC, Buettner R, Kirfel J, Eggert A, Schramm A, Schulte JH, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Kwiecien R, Pietsch T, Warmuth-Metz M, Faldum A, Kuehl J, Kortmann RD, Rutkowski S, Lupo P, Scheurer M, Martin A, Nirschl C, Polanczyk M, Cohen KJ, Pardoll DM, Drake CG, Lim M, Manoranjan B, Hallett R, Wang X, Venugopal C, McFarlane N, Sheinemann K, Hassell J, Singh S, Venugopal C, Manoranjan B, McFarlane N, Whitton A, Delaney K, Scheinemann K, Singh S, Manoranjan B, Hallett R, Venugopal C, McFarlane N, Hassell J, Scheinemann K, Dunn S, Singh S, Garcia I, Crowther AJ, Gama V, Miller CR, Deshmukh M, Gershon TR, Garcia I, Crowther AJ, Gershon TR, Gerber NU, von Hoff K, Friedrich C, von Bueren AO, Treulieb W, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Rutkowski S, Kortmann RD, Zin A, De Bortoli M, Bonvini P, Viscardi E, Perilongo G, Rosolen A, Connolly E, Zhang C, Anderson R, Feldstein N, Stark E, Garvin J, Shing MMK, Lee V, Cheng FWT, Leung AWK, Zhu XL, Wong HT, Kam M, Li CK, Ward S, Sengupta R, Kroll K, Rubin J, Dallas P, Milech N, Longville B, Hopkins R, Vergiliana JVD, Endersby R, Gottardo N, von Bueren AO, Gerss J, Hagel C, Cai H, Remke M, Hasselblatt M, Feuerstein BG, Pernet S, Delattre O, Korshunov A, Rutkowski S, Pfister SM, Baudis M, Lee C, Fotovati A, Triscott J, Dunn S, Valdora F, Freier F, Seyler C, Brady N, Bender S, Northcott P, Kool M, Jones D, Coco S, Tonini GP, Scheurlen W, Boutros M, Taylor M, Katus H, Kulozik A, Zitron E, Korshunov A, Lichter P, Pfister S, Remke M, Shih DJH, Northcott PA, Van Meter T, Pollack IF, Van Meir E, Eberhart CG, Fan X, Dellatre O, Collins VP, Jones DTW, Clifford SC, Pfister SM, Taylor MD, Pompe R, von Bueren AO, von Hoff K, Friedrich C, Treulieb W, Lindow C, Deinlein F, Kuehl J, Rutkowski S, Gupta T, Krishnatry R, Shirsat N, Epari S, Kunder R, Kurkure P, Vora T, Moiyadi A, Jalali R, Cohen K, Perek D, Perek-Polnik M, Dembowska-Baginska B, Drogosiewicz M, Grajkowska W, Lastowska M, Chojnacka M, Filipek I, Tarasinska M, Roszkowski M, Hauser P, Jakab Z, Bognar L, Markia B, Gyorsok Z, Ottoffy G, Nagy K, Cservenyak J, Masat P, Turanyi E, Vizkeleti J, Krivan G, Kallay K, Schuler D, Garami M, Lacroix J, Schlund F, Adolph K, Leuchs B, Bender S, Hielscher T, Pfister S, Witt O, Schlehofer JR, Rommelaere J, Witt H, Leskov K, Ma N, Eberhart C, Stearns D, Dagri JN, Torkildson J, Evans A, Ashby LS, Zakotnik B, Brown RJ, Dhall G, Portnow J, Finlay JL, McCabe M, Pizer B, Marino AM, Baryawno N, Ekstrom TP, Ostman A, Johnsen JI, Robinson G, Parker M, Kranenburg T, Lu C, Pheonix T, Huether R, Easton J, Onar A, Lau C, Bouffet E, Gururangan S, Hassall T, Cohn R, Gajjar A, Ellison D, Mardis E, Wilson R, Downing J, Zhang J, Gilbertson R, Robinson G, Dalton J, O'Neill T, Yong W, Chingtagumpala M, Bouffet E, Bowers D, Kellie S, Gururangan S, Fisher P, Bendel A, Fisher M, Hassall T, Wetmore C, Broniscer A, Clifford S, Gilbertson R, Gajjar A, Ellison D, Zhukova N, Martin D, Lipman T, Castelo-Branco P, Zhang C, Fraser M, Baskin B, Ray P, Bouffet E, Alman B, Ramaswamy V, Dirks P, Clifford S, Rutkowski S, Pfister S, Bristow R, Taylor M, Malkin D, Hawkins C, Tabori U, Dhall G, Ji L, Haley K, Gardner S, Sposto R, Finlay J, Leary S, Strand A, Ditzler S, Heinicke G, Conrad L, Richards A, Pedro K, Knoblaugh S, Cole B, Olson J, Yankelevich M, Budarin M, Konski A, Mentkevich G, Stefanits H, Ebetsberger-Dachs G, Weis S, Haberler C, Milosevic J, Baryawno N, Sveinbjornsson B, Martinsson T, Grotzer M, Johnsen JI, Kogner P, Garzia L, Morrisy S, Jelveh S, Lindsay P, Hill R, Taylor M, Marks A, Zhang H, Rood B, Williamson D, Clifford S, Aurtenetxe O, Gaffar A, Lopez JI, Urberuaga A, Navajas A, O'Halloran K, Hukin J, Singhal A, Dunham C, Goddard K, Rassekh SR, Davidson TB, Fangusaro JR, Ji L, Sposto R, Gardner SL, Allen JC, Dunkel IJ, Dhall G, Finlay JL, Trivedi M, Tyagi A, Goodden J, Chumas P, O'kane R, Crimmins D, Elliott M, Picton S, Silva DS, Viana-Pereira M, Stavale JN, Malheiro S, Almeida GC, Clara C, Jones C, Reis RM, Spence T, Sin-Chan P, Picard D, Ho KC, Lu M, Huang A, Bochare S, Khatua S, Gopalakrishnan V, Chan TSY, Picard D, Pfister S, Hawkins C, Huang A, Chan TSY, Picard D, Ho KC, Huang A, Picard D, Millar S, Hawkins C, Rogers H, Kim SK, Ra YS, Fangusaro J, Toledano H, Nakamura H, Van Meter T, Pomeroy S, Ng HK, Jones C, Gajjar A, Clifford S, Pfister S, Eberhart C, Bouffet E, Grundy R, Huang A, Sengupta S, Weeraratne SD, Phallen J, Sun H, Rallapalli S, Amani V, Pierre-Francois J, Teider N, Cook J, Jensen F, Lim M, Pomeroy S, Cho YJ. MEDULLOBLASTOMA. Neuro Oncol 2012; 14:i82-i105. [PMCID: PMC3483339 DOI: 10.1093/neuonc/nos093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
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Ibanez J, Brell M, Tomas M, Roldan P, Guibelalde M, Tavera A, Salinas JA, Suzuki T, Fukuoka K, Kohga T, Yanagisawa T, Adachi J, Mishima K, Fujimaki T, Matsutani M, Ishihara S, Nishikawa R, Keating R, DeFreitas T, Al Abbas F, Myseros J, Yaun A, Magge S, Pettorini B, Al-Mahfoudh R, Yousaf J, Pizer B, Jenkinson M, Mallucci C, Pettorini B, Parlato S, Yousaf J, Pizer B, Kumar R, Avula S, Mallucci C, Munoz M, Yano H, Ohe N, Nakayama N, Shinoda J, Iwama T, Rahman C, Smith S, Morgan P, Langmack K, Macarthur D, Rose F, Shakesheff K, Grundy R, Rahman R, Krieger M, Si SJ, Flores N, Haley K, Malvar J, Sposto R, Fangusaro J, Dhall G, Davidson TB, Finlay J, Caretti V, Lagerweij T, Schellen P, Jansen M, van Vuurden DG, Hulleman E, Idema S, Vandertop WP, Noske DP, Kaspers G, Wurdinger T, Luther N, Zhou Z, Zanzonico P, Cheung NK, Souweidane M, Kotecha R, Pascoe E, Rushing E, Rorke-Adams L, Zwerdling T, Gao X, Li X, Greene S, Amirjamshidi A, Kim SK, Lima M, Hung PC, Lakhdar F, Mehta N, Liu Y, Devi BI, Sudhir BJ, Lund-Johansen M, Gjerris F, Cole C, Gottardo N, Dorfer C, Slavc I, Dieckmann K, Gruber K, Schmook M, Czech T, Griffin A, Greenfield J, Souweidane M, Lulla RR, Rao V, Haridas A, Ryan M, Goldstein JL, Wainwright M, Tomita T. NEUROSURGERY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yano H, Nakayama N, Hirose Y, Ohe N, Shinoda J, Yoshimura SI, Iwama T. Intraventricular glioneuronal tumor with disseminated lesions at diagnosis--a case report. Diagn Pathol 2011; 6:119. [PMID: 22145948 PMCID: PMC3251541 DOI: 10.1186/1746-1596-6-119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 12/06/2011] [Indexed: 01/05/2023] Open
Abstract
A 55-year-old man presented with a large tumor in his lateral ventricles. Magnetic resonance imaging revealed disseminated lesions in the third and fourth ventricles at the time of diagnosis. The patient underwent a partial removal of the tumor in the lateral ventricles. Histologically, the surgical specimens showed glioneuronal differentiation with ganglion or ganglioid cells, Rosenthal fibers, oligodendroglia-like honeycomb appearances, a spongy pattern, perivascular pseudorosettes, and many hyalinized blood vessels. Papillary structure was not observed. The neuronal component showed a moderately high labeling index of Ki-67/MIB-1. We diagnosed this tumor as atypical intraventricular glioneuronal tumor. The disseminated lesions disappeared after chemoradiation therapy with temozolomide, and the residual tumors in the lateral ventricles remained stable for 3 years after the surgery. We discuss the pathological diagnosis, therapy and clinical course with review of the literatures.
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.
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Ozeki M, Funato M, Teramoto T, Ohe N, Asano T, Kaneko H, Fukao T, Kondo N. Reversible cerebrospinal fluid edema and porencephalic cyst, a rare complication of ventricular catheter. J Clin Neurosci 2010; 17:658-61. [DOI: 10.1016/j.jocn.2009.07.122] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 07/23/2009] [Accepted: 07/24/2009] [Indexed: 11/26/2022]
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Okada M, Saio M, Kito Y, Ohe N, Yano H, Yoshimura S, Iwama T, Takami T. Tumor-associated macrophage/microglia infiltration in human gliomas is correlated with MCP-3, but not MCP-1. Int J Oncol 2009; 34:1621-7. [PMID: 19424580 DOI: 10.3892/ijo_00000292] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The monocyte chemotactic protein 3 (MCP-3) belongs to the MCP subgroup of the CC chemokines and promotes chemotaxis of immune cells. MCP-1 is believed to play an important role in monocyte infiltration into tumor tissues; however, the relationship between tumor-infiltrating macrophage/microglia (TIM/M) and the expression of chemokines has not been investigated in detail in human glioma samples; therefore, we first examined the expression of several chemokines and chemokine receptors in human tumor cell lines, which included glioma lines, using real-time PCR. We found that several glioma lines expressed MCP-3 predominantly, and not MCP-1. In order to assess the significance of MCP-3 expression in human glioma tissues, we then examined the number of CD68+ TIM/M, the percentage of TIM/M in the total cell population, and the expression of MCP-1 and MCP-3 in glioma tissues. There was a correlation between the percentage of TIM/M and MCP-3 expression levels; however, there was no correlation between the percentage of TIM/M and MCP-1 expression. There was no correlation between the number of TIM/M and prognosis of patients. These data indicate that tumor cell-derived MCP-3, but not MCP-1, facilitates the infiltration of macrophage/microglia into tumor tissues. This is the first study that clearly compared the significance of MCP-3 with that of MCP-1 in the tumor infiltration rates of TIM/M.
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Affiliation(s)
- Makoto Okada
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu-city, Gifu 501-1194, Japan
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Yano H, Ohe N, Shinoda J, Yoshimura SI, Iwama T. Immunohistochemical study concerning the origin of neurocytoma--a case report. Pathol Oncol Res 2008; 15:301-5. [PMID: 18802789 DOI: 10.1007/s12253-008-9106-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Accepted: 09/02/2008] [Indexed: 11/29/2022]
Abstract
A 26-year-old woman presented with rapid tumor growth in her left frontal lobe during 9 years of observation. Operative findings revealed a massive tumor connected to gelatinous, transparent membranous tissue (MT), which extended from the paraventricular zone and continued into the lateral ventricle. Histological diagnosis was atypical neurocytoma. Immunohistochemical analyses revealed that the tumor was strongly positive for not only neural markers but also a glial marker, while the MT was positive for a neural marker. The Ki-67/MIB-1 labeling index was 9.1% in the tumor body and 0% in the MT. Musashi 1, a marker of neural stem cells, was strongly positive in both the tumor body and the MT. We speculate that the tumor growth was due to a rapid decline of the Musashi 1-positive cells to glial differentiation. These cells may be candidates for the origin of the tumor.
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan.
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Abstract
A 33-year-old woman presented with a rare intracranial pial arteriovenous fistula manifesting as monoparesis and hypesthesia of the right lower extremity. Computed tomography demonstrated an approximately 10-mm diameter subcortical hematoma in the left postcentral gyrus. Two months after suffering the ictus, angiography demonstrated a pial arteriovenous fistula in the late arterial phase fed by the left paracentral artery and drained into the left precentral vein. No nidus or dural arteriovenous fistula was detected. Left parietal craniotomy was performed and the pial arteriovenous fistula was extirpated by electrocoagulation. Intraoperative angiography demonstrated disappearance of the fistula. She experienced no postoperative neurological deterioration, but hypesthesia of the right leg persisted. Obliteration of the pial arteriovenous fistula was reconfirmed by postoperative angiography. She suffered no rebleeding episodes during the 36-month follow-up period. Pial arteriovenous fistula causing mild symptoms should be treated by flow disconnection because the direct arteriovenous shunt and attendant high blood flow usually results in huge venous varices. To determine whether direct surgery or endovascular treatment is appropriate, the position and shape of the lesion must be known.
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Affiliation(s)
- Kentaro Yamashita
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Yanagido, Gifu, Japan.
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Iwama T, Yoshimura S, Yano H, Ohe N, Takenaka M, Iida H. [Infratentorial supracerebellar approach for pineal lesions]. No Shinkei Geka 2007; 35:453-66. [PMID: 17491341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Toru Iwama
- Department of Neurosurgery, Gifu University School of Medicine, Yanagido, Gifu City, Gifu, Japan.
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Nakagawa J, Saio M, Tamakawa N, Suwa T, Frey AB, Nonaka K, Umemura N, Imai H, Ouyang GF, Ohe N, Yano H, Yoshimura S, Iwama T, Takami T. TNF expressed by tumor-associated macrophages, but not microglia, can eliminate glioma. Int J Oncol 2007; 30:803-11. [PMID: 17332918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
It is well known that tumor necrosis factor (TNF) can have both contrary and pleiotropic effects in anti-tumor immune response. In the present study, we prepared two different tumor cell-based immunotherapy models: MCA38 adenocarcinoma and GL261 glioma intracranial interleukin-2 (IL-2)-based. Each tumor was transfected to express IL-2 with or without expression of the soluble form of tumor necrosis factor receptor type II (sTNFRII). Although mice in which TNF is blocked survive longer than IL-2 alone (35.2 versus 26 days), the reverse was observed for GL261 glioma. The differential effect on tumor growth implies enhanced TNF sensitivity of GL261 compared to MCA38. This notion is supported by the observation that TNF induces apoptosis in GL261 but not MCA38 tumors. We further examined tumor infiltrating CD11b+F4/80+ macrophages (or tumor-associated macrophages: TAM) for TNF production in vivo and found that TAM express cell surface TNF implying a role in eliminating glioma cells mediated by the cell surface form of TNF.
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Affiliation(s)
- Jiro Nakagawa
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
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Nakagawa J, Saio M, Tamakawa N, Suwa T, Frey A, Nonaka K, Umemura N, Imai H, Ouyang GF, Ohe N, Yano H, Yoshimura S, Iwama T, Takami T. TNF expressed by tumor-associated macrophages, but not microglia, can eliminate glioma. Int J Oncol 2007. [DOI: 10.3892/ijo.30.4.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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36
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Kono T, Ebisawa Y, Chisato N, Asama T, Tomita I, Yamamoto Y, Ohe N, Ayabe T, Ashida T, Kasai S. A multicenter phase II study of “adjuvant” bi-weekly Irinotecan, infusional 5-fluorouracil (5FU) and leucovorin (LV) with oral tegafur/uracil (UFT) following resection of colorectal hepatic metastases. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- T. Kono
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - Y. Ebisawa
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - N. Chisato
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - T. Asama
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - I. Tomita
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - Y. Yamamoto
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - N. Ohe
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - T. Ayabe
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - T. Ashida
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
| | - S. Kasai
- Asahikawa Medcl Coll, Asahikawa, Japan; Kobayashi Hosp, Kitami, Japan; Yubari City Hosp, Yubari, Japan
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Kato M, Ohe N, Okumura A, Shinoda J, Nomura A, Shuin T, Sakai N. Hemangioblastomatosis of the central nervous system without von Hippel–Lindau Disease: a case report. J Neurooncol 2005; 72:267-70. [PMID: 15937651 DOI: 10.1007/s11060-004-2244-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report a very rare case of hemangioblastomatosis in a patient without von Hippel-Lindau disease (VHL). A 50-year-old woman had a history of surgical procedures for total removal of a cerebellar hemangioblastoma (HB). Twenty-one years after the last operation, she developed communicating hydrocephalus; computed tomographic (CT) scans of the brain showed no recurrence of HB in the posterior fossa. Subsequently, she underwent placement of a ventriculo-peritoneal shunt. One year later, she was readmitted because of progressive numbness and pain in the left lower limb. Magnetic resonance imaging (MRI) showed multiple Gd-enhancing tumors around the brain stem, in the cerebellum, and in the cervical and thoracolumbar regions of the spine. She underwent surgical removal of the tumors in the cerebellum and spinal cord. Although the extirpated tissues were histopathologically verified HB with less than 1% MIB-1 labeling index, surgery was followed by external beam radiation therapy with doses of 40 Gy to the whole brain, 10 Gy to the posterior fossa and 30 Gy to the whole spine. However, she subsequently developed quadriparesis and became bedridden.
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Affiliation(s)
- Masayasu Kato
- Department of Neurosurgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
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Egashira Y, Ikegame Y, Aki T, Ohe N, Yano H, Ueda T, Shinoda J, Iwama T. Surgical Treatment of a Ruptured Traumatic Anterior Cerebral Artery Aneurysm : Report of Two Cases. ACTA ACUST UNITED AC 2005. [DOI: 10.7887/jcns.14.635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yusuke Egashira
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Yuka Ikegame
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Tatsuki Aki
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Tatsuya Ueda
- Department of Neurosurgery, Kizawa Memorial Hospital
| | - Jun Shinoda
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine
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Tamakawa N, Saio M, Suwa T, Ohe N, Yoshimura SI, Iwama T, Shinoda J, Sakai N, Takami T. Interleukin-2 activated microglia engulf tumor infiltrating T cells in the central nervous system. Int J Mol Med 2004. [DOI: 10.3892/ijmm.13.4.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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40
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Tamakawa N, Saio M, Suwa T, Ohe N, Yoshimura SI, Iwama T, Shinoda J, Sakai N, Takami T. Interleukin-2 activated microglia engulf tumor infiltrating T cells in the central nervous system. Int J Mol Med 2004; 13:497-503. [PMID: 15010848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Interleukin-2 (IL-2) has been utilized to treat cancer patient. However, recent studies disclosed that IL-2 induces T cell death. To clarify IL-2 induced T cell apoptosis at tumor sites in the central nervous system (CNS), we utilized an intracranial implantation of IL-2 cDNA transduced murine tumor cells and examined freshly recovered tumor infiltrating T lymphocytes (TIL) with a magnetic beads separation method. CD8(+) TIL recovered from the IL-2 therapy model had three times more apoptosis than a control group, tumor weights at day 12 decreased (0.016 versus 0.041 g/mouse) and the number of TIL per gram of tumor tissue increase more than six times by IL-2 therapy (5.69x10(6) versus 33.7x10(7) cells per mouse). In addition, both activation marker expressions (CD25 and CD69) and cytokine message levels (interferon gamma, and tumor necrosis factor alpha) on CD8(+) TIL decrease in the IL-2 therapy model. Moreover, we detected higher CD8beta message levels in purified tumors associated with F4/80(+) cells from the IL-2 model than the control by a one-step RT-PCR method. Finally, we observed many CD8beta(+) TIL surrounded by numerous infiltrating F4/80(+) cells in the tumor tissues of the IL-2 therapy model by immuno-fluorescence microscopic analysis. Our data show that IL-2 sensitization of apoptosis induction for CD8(+) TIL occurred and the apoptotic T cells were eliminated by F4/80(+) microglia in the CNS. Moreover, this is the first report describing in situ elimination of TIL by F4/80(+) phagocytic cells in the CNS.
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MESH Headings
- Animals
- Annexin A5/pharmacology
- Antigens, CD/biosynthesis
- Antigens, Differentiation, T-Lymphocyte/biosynthesis
- Apoptosis
- CD8-Positive T-Lymphocytes/metabolism
- CD8-Positive T-Lymphocytes/pathology
- Cell Line, Tumor
- Central Nervous System/metabolism
- Central Nervous System/pathology
- DNA, Complementary/metabolism
- Enzyme-Linked Immunosorbent Assay
- Flow Cytometry
- Immunohistochemistry
- Interferon-gamma/biosynthesis
- Interleukin-2/metabolism
- Interleukin-2/therapeutic use
- Lectins, C-Type
- Lymphocytes, Tumor-Infiltrating/metabolism
- Lymphocytes, Tumor-Infiltrating/pathology
- Male
- Mice
- Mice, Inbred C57BL
- Microglia/metabolism
- Microglia/pathology
- Microscopy, Fluorescence
- Plasmids/metabolism
- RNA, Messenger/metabolism
- Receptors, Interleukin-2/biosynthesis
- Reverse Transcriptase Polymerase Chain Reaction
- Time Factors
- Transfection
- Tumor Necrosis Factor-alpha/biosynthesis
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Affiliation(s)
- Noriyuki Tamakawa
- Department of Neurosurgery, Gifu University School of Medicine, Gifu, Japan
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Shinoda J, Yano H, Ando H, Ohe N, Sakai N, Saio M, Shimokawa K. Radiological response and histological changes in malignant astrocytic tumors after stereotactic radiosurgery. Brain Tumor Pathol 2003; 19:83-92. [PMID: 12622138 DOI: 10.1007/bf02478932] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Stereotactic radiosurgery is an encouraging approach to deliver higher doses of radiation boost for malignant gliomas safely and precisely. The purpose of this study was to investigate the radiation response and histological changes of malignant astrocytic tumors after stereotactic linac radiosurgery (SLRS). We studied an autopsy case of recurrent glioblastoma multiforme (GBM) and two surgical cases with gross total removal of recurrent GBM and anaplastic astrocytoma transformed from fibrillary astrocytoma treated with SLRS. Destructive changes, such as the disappearance of viable cells, coagulation necrosis, and fibrinoid degeneration of vascular walls, were observed in the center of the target of SLRS, which showed histologically similar radiobiological reactions to well-known delayed central nervous system radiation necrosis caused by conventional radiotherapy. The region showing such radiation necrosis was within the area irradiated with approximately 15-20Gy or more by SLRS; however, dense viable tumor cells remained in the periphery that was irradiated with less than 15Gy. In a comparative immunohistochemical study of the tumors before and after SLRS, neither MIB-1 and p53 labeling indices nor immunoreactivity for GFAP represented any persistent tendencies. There were very few TUNEL-positive cells in either tumor before and after SLRS. These results showed that radiosurgery for malignant gliomas leads to earlier radiation necrosis than conventional radiation and that it is useful in eradicating tumor cells in the center of the target. However, some viable tumor cells may remain in the periphery irradiated with an insufficient dose for cell death and may be partly transformed in character by DNA damage due to radiation. Proton magnetic resonance spectroscopy (MRS) was suggested to characterize the radiation response in radiosurgery tumor targets for correlation with histological findings.
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Affiliation(s)
- Jun Shinoda
- Department of Neurosurgery, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500-8705, Japan.
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42
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Ohe N, Saio M, Kijima M, Tamakawa N, Suwa T, Kojima Y, Yano H, Kaku Y, Iwama T, Shinoda J, Sakai N, Takami T. In situ detection of O6-methylguanine-DNA methyltransferase messenger RNA in paraffin-embedded human astrocytic tumor tissues by nested in situ RT-PCR is useful in predicting chemotherapy-resistance of tumors. Int J Oncol 2003; 22:543-9. [PMID: 12579307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
O6-methylguanine-DNA methyltransferase (MGMT) is an enzyme that interferes with chemotherapeutic effect of alkylating agents. We performed in situ detection of MGMT mRNA utilizing the nested RT-PCR method in tissue sections (nested in situ RT-PCR). We analyzed 34 samples of paraffin-embedded astrocytic tumor tissue sections with this method [3 astrocytomas, 14 anaplastic astrocytomas (AA), and 17 glioblastoma multiformes (GBM)]. Twenty-five cases (73.5% of all cases) were positive for MGMT either with our method or immunohistochemistry (IHC). Moreover, with our method >25% of the cells in the tumor tissue expressed MGMT in contrast to >4% with IHC among the population of MGMT positive cases. Our method was significantly more sensitive than IHC (p=0.0004). The present results suggest that potentially there is a greater population of MGMT positive cells in astrocytic tumor tissues than the one evaluated with IHC. These findings suggest that the >25% of the MGMT positive cells are involved in the interference with the chemotherapeutic effect of alkylating agents. The MGMT expressing cell population was markedly decreased in GBM compared with AA (26.1% vs 62.1%). The main reason for this marked decrease was that MGMT was expressed in only 9 of 17 cases of GBM in contrast to all AA cases that expressed MGMT. This result suggests that there are potentially two populations of GBM on the basis of MGMT expression, in which the negative population might be mainly composed of de novo GBM. Therefore, it is suggested that our method is practically useful to detect any drug resistance gene product with high sensitivity and would provide a chance to evaluate the chemotherapeutic effect of any agents in an individual patient based manner.
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Affiliation(s)
- Naoyuki Ohe
- Department of Neurosurgery, Gifu University School of Medicine, Gifu 500-8705, Japan
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Ando H, Saio M, Tamakawa N, Ohe N, Nakayama T, Yu H, Kaku Y, Iwama T, Shinoda J, Sakai N, Takami T. Failure of B7.1-modified tumor to evoke full activation of CD8+ tumor-infiltrating lymphocytes in the central nervous system: prevention of parental tumor growth in the subcutaneous environment. J Neurosurg 2002; 97:432-40. [PMID: 12186473 DOI: 10.3171/jns.2002.97.2.0432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT It is well known that the central nervous system (CNS) is an immunologically privileged site. To characterize CD8+ tumor-infiltrating lymphocytes (TILs) recovered from the CNS, the authors compared these cells with TILs recovered from subcutaneous tissue by using a B7.1 gene-modified tumor implantation model. METHODS The authors established a B7.1 gene-modified EL4 murine lymphoma cell line (EL4-B7.1) and implanted the cells into the CNS to observe the duration of tumor-free survival. Although EL4-B7.1 cells were completely rejected in a subcutaneous implantation model, 40% of animals died after the CNS implantation (all animals in which the parent tumor was implanted died within 16 days). Therefore, the authors isolated TILs from each implantation site and analyzed the expressions of activation antigens CD25 and CD69 by performing the anti-CD8 magnetic beads separation method and flow cytometric analysis. After implantation of the parent tumor, there was no difference in the number of TILs from each site (CD25 1.7-3.2%, CD69 21.9-34.3%). After implantation of the B7.1-modified tumor, the CD25-expressing TIL population from the subcutaneous site was 4.68 times higher than that from the CNS site (17.8% compared with 3.8%). Based on these findings, the authors used a mitomycin C-treated EL4-B7.1 subcutaneous vaccination with various protocols. Vaccination before tumor challenge was sufficient to prevent the development of the tumor. For animals with established tumor, the vaccination protocol was able to prolong host survival (p = 0.0053). CONCLUSIONS The data clearly demonstrate that the CNS environment fails to activate CD8+ TILs fully. These are the first data indicating in detail a difference between CD8+ TILs from the CNS and those from other sites based on a B7.1-modified tumor model.
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Affiliation(s)
- Hiromichi Ando
- Department of Neurosurgery, Gifu University School of Medicine, Japan
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Ando H, Saio M, Ohe N, Tamakawa N, Yu H, Nakayama T, Yoshimura SI, Kaku Y, Iwama T, Shinoda J, Sakai N, Takami T. B7.1 immunogene therapy effectively activates CD(4+) tumor-infiltrating lymphocytes in the central nervous system in comparison with B7.2 gene therapy. Int J Oncol 2002; 20:807-12. [PMID: 11894129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The B7 gene utilizing immunogene therapy is one of the most common methods against tumor growth. However, there is no known study that investigated the difference between B7.1 and B7.2 with regard to B7 gene therapy in the central nervous system (CNS). Therefore, to clarify the difference, we established B7.1 or B7.2 gene transduced tumor cells originating from the murine T cell lymphoma cell line EL4 (EL4-B7.1 or EL4-B7.2). First, we observed the survival time after intracranial inoculation of parent (IC-wt) or genetically modified tumor cells. All mice in control groups (IC-wt or IC-mock) were dead within 16 days. While there was significant survival elongation in the B7.2 modified group (IC-B7.2, p=0.0002), all mice in this group were dead of tumor growth within 22 days. On the other hand, 60% of mice inoculated with EL4-B7.1 (IC-B7.1) survived more than 120 days (p<0.0001). Second, to shed light on the anti-tumor immune response in situ, we tried to analyze CD(4+) tumor-infiltrating T lymphocytes (CD(4+) TIL). To purify and analyze CD(4+) TIL, we had to deplete F4/80(+) microglia because of the CD4 expression. In terms of activation marker expression in CD(4+) TIL, a small population was activated (CD25, 9.8%; CD69, 15.8%) in the control group (IC-wt). In contrast, the activation marker positive CD4+ TIL percentage both in IC-B7.1 (CD25, 25.1%; CD69, 40.1%) and IC-B7.2 (CD25, 16.2%; CD69, 28.3%) appeared to reflect the survival curve in both groups. These findings strongly suggest that, in the CNS, B7.1 gene therapy could effectively introduce CD(4+) TIL activation compared with B7.2 gene therapy. This is the first study clearly describing the difference between B7.1 gene therapy and B7.2 gene therapy in the CNS in terms of the activation status of CD(4+) TIL in situ.
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Affiliation(s)
- Hiromichi Ando
- Department of Neurosurgery, Gifu University School of Medicine, Gifu 500-8705, Japan
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Ando H, Saio M, Ohe N, Tamakawa N, Yu H, Nakayama T, Yoshimura SI, Kaku Y, Iwama T, Shinoda J, Sakai N, Takami T. B7.1 immunogene therapy effectively activates CD4+ tumor-infiltrating lymphocytes in the central nervous system in comparison with B7.2 gene therapy. Int J Oncol 2002. [DOI: 10.3892/ijo.20.4.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Saito K, Tomigahara Y, Ohe N, Isobe N, Nakatsuka I, Kaneko H. Lack of significant estrogenic or antiestrogenic activity of pyrethroid insecticides in three in vitro assays based on classic estrogen receptor alpha-mediated mechanisms. Toxicol Sci 2000; 57:54-60. [PMID: 10966511 DOI: 10.1093/toxsci/57.1.54] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Estrogenic and antiestrogenic activity of pyrethroid insecticides (d-trans-allethrin, cypermethrin, empenthrin, fenvalerate, imiprothrin, permethrin, d-phenothrin and prallethrin) was evaluated using a suite of three in vitro assays based on classic human estrogen receptor alpha (hER alpha)-mediated mechanisms. A mammalian cell-based luciferase reporter gene assay was developed for examining effects on hER alpha-mediated gene activation. hER alpha-independent effects on the gene activation were examined using control cells with constitutive luciferase activation by a herpes simplex virus thymidine kinase (HSV-TK) promoter for determining appropriate dose levels of test chemicals. Moreover, the test chemical-dependent interaction between hER alpha and a coactivator (transcriptional intermediary factor 2: TIF2) was analyzed by a yeast two-hybrid method, competitive binding to hER alpha being assayed by a fluorescence polarization method. Significant (p < 0.05) positive effects of estrogenic substances (E2/estradiol, diethylstilbestrol, and p-nonylphenol) were detected in all assays. An antiestrogen, 4-hydroxytamoxifen, significantly inhibited E2-mediated transactivation and interaction between hER alpha and TIF2 through hER alpha binding (p < 0.05). However, none of the pyrethroids tested showed significant (p < 0.05) estrogenic or antiestrogenic effects (100 nM-10 microM), indicating that they do not impact on the classic hER alpha-mediated activation pathway in vitro.
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Affiliation(s)
- K Saito
- Environmental Health Science Laboratory, Sumitomo Chemical Company, Limited., 1-98, 3-Chome, Kasugade-Naka, Konohana-Ku, Osaka 554-8558, Japan.
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Abstract
Secondary tethered cord syndrome following initial repair for spinal dysraphism is an important area of interest. In this study, 32 cases with spinal dysraphism in the lumbosacral region were enrolled, in whom radical repair with autologous material had been carried out in the early stage soon after birth. During the follow-up period of up to 19 years 10 months, surgery was considered to be indicated in 2 of the 8 lipomeningocele cases and in 6 of the 24 meningocele and meningomyelocele cases, because of the presence of tethered cord syndrome 4-19 years after the primary operation. In all 8 of these cases, MR imaging demonstrated tethered spinal cord in the form of low conus medullaris. In 6 of the 8 operated cases surgery was followed by improvement of the spinal neurological deterioration. According to our experience, early untethering for secondary tethered cord syndrome is essential. In addition, since the complications of Silastic duraplasty at untethering were all minor and the operative outcome was satisfactory, the use of silicone rubber sheeting as a dural substitute might be recommended to prevent adhesion of the spinal cord.
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Affiliation(s)
- N Ohe
- Department of Neurosurgery, Nagara National Hospital, Gifu, Japan
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Muroya T, Ohe H, Sakai H, Harada T, Numata T, Ohe N, Ikeda S, Miyahara Y, Kohno S. A case in which stent insertion is considered to have triggered contrast medium-induced coronary vasospasm. Jpn Circ J 1999; 63:315-8. [PMID: 10475782 DOI: 10.1253/jcj.63.315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A Gianturco-Roubin II (GR-II) stent was inserted in a 75-year-old man who developed restenosis of the right coronary artery (RCA) after percutaneous transluminal coronary angioplasty (PTCA). Although the vessel became partially occluded after 7 months, it was redilated by PTCA. Follow-up angiography of the RCA and left coronary artery (LCA) was performed 3 months later. Chest pain with bradycardia and hypotension occurred immediately after this examination, and ST elevation appeared in ECG leads II, III, and aVF. Repeat angiography of the RCA confirmed complete occlusion due to a spasm at a site proximal to the GR-II stent. The spasm was resolved by intracoronary infusion of isosorbide dinitrate (ISDN), and PTCA was carried out for extensive recurrent restenosis of the RCA; however, vascular dissection developed at the distal end of the GR-II stent. Therefore, a Palmaz-Schatz (P-S) stent was placed such that its proximal end overlapped the distal end of the GR-II stent. Follow-up angiography 3 months later showed no restenosis, but an episode of vasospasm similar to the previous one occurred immediately after left ventriculography. The RCA was completely occluded proximal to the GR-II stent because of spasm. Although this spasm was gradually relieved by intracoronary infusion of ISDN, marked spasm was also observed distal to the P-S stent; complete relief was achieved by infusion of additional ISDN.
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Affiliation(s)
- T Muroya
- Department of Cardiology, Kitakyushu City Yahata Hospital, Fukuoka, Japan
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Niikawa S, Kitajima H, Ohe N, Miwa Y, Ohkuma A. Significance of acute cerebral swelling in patients with sylvian hematoma due to ruptured middle cerebral artery aneurysm, and its management. Neurol Med Chir (Tokyo) 1998; 38:844-8; discussion 849-50. [PMID: 10063358 DOI: 10.2176/nmc.38.844] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A retrospective study of 75 patients treated surgically for ruptured middle cerebral artery (MCA) aneurysm within 48 hours evaluated clinical grade at admission, secondary development and management of cerebral swelling associated with space-occupying hematoma, cerebral infarction caused by vasospasm, development of hydrocephalus, and clinical outcome. Clinical grade at admission was significantly better in patients without than in those with hematoma (p < 0.01). Twenty-seven patients with sylvian hematoma caused by ruptured MCA aneurysm often developed ipsilateral cerebral swelling in the early period after subarachnoid hemorrhage. Seventeen of these patients developed serious cerebral swelling and received barbiturate therapy. Nine of these 17 patients had good outcome, but six patients died of cerebral swelling. The incidence of hydrocephalus was significantly higher in patients with than in those without hematoma (p < 0.01). The incidence of infarction was more pronounced in patients with sylvian hematoma. Clinical outcome was significantly better in patients without than in those with sylvian hematoma (p < 0.01). Development of cerebral swelling in patients with sylvian hematoma due to ruptured MCA aneurysm has a significant effect on outcome, and improvements in management are required.
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Affiliation(s)
- S Niikawa
- Department of Neurosurgery, Prefectural Gifu Hospital, Japan
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Niikawa S, Hara S, Ohe N, Miwa Y, Ohkuma A. Correlation between blood parameters and symptomatic vasospasm in subarachnoid hemorrhage patients. Neurol Med Chir (Tokyo) 1997; 37:881-4; discussion 884-5. [PMID: 9465585 DOI: 10.2176/nmc.37.881] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Serial changes in platelet and white blood cell (WBC) counts and other blood parameters were analyzed in 103 patients with aneurysmal subarachnoid hemorrhage (SAH). The WBC counts during days 3-5, 6-8, 9-11, and 12-14 after the onset of SAH were significantly higher in patients with than in patients without symptomatic vasospasm. Platelet counts during days 0-2, 3-5, 6-8, 9-11, 12-14, 15-17, 18-21, and 22-28 after SAH were significantly higher in patients with than in patients without symptomatic vasospasm. Monitoring of platelet and WBC counts may provide an indicator of the occurrence of symptomatic vasospasm.
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Affiliation(s)
- S Niikawa
- Department of Neurosurgery, Prefectural Gifu Hospital
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