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大学院医学系研究科（医学専攻等） 医学専攻 機能展開医学系 脳神経外科学講座 |
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秋田市本道1-1-1 |
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018-884-6140 |
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清水 宏明 (シミズ ヒロアキ)
SHIMIZU Hiroaki
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学会（学術団体）・委員会 【 表示 ／ 非表示 】
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1986年06月-継続中
日本国
日本脳神経外科学会
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1991年04月-継続中
日本国
日本脳卒の外科学会
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1991年04月-継続中
日本国
日本脳卒中学会
研修受講歴 【 表示 ／ 非表示 】
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2019年07月-2019年08月
研究者・大学院生向けコース（生命医科学）カリキュラム
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2014年10月
臨床研究の基礎知識講座（旧 臨床研究入門初級編）
学位論文 【 表示 ／ 非表示 】
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ラット全脳虚血モデルにおける脳内神経伝達アミノ 酸とエネルギー代謝の動態及び相関に関する研究
H Shimizu, S H Graham, L H Chang, J Mintorovitch, T L James, A I Faden, P R Weinstein
Brain Research 605 ( 1 ) 33 - 42 1992年03月 [査読有り]
国際共著
研究等業績 【 表示 ／ 非表示 】
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Masamichi Abe, Takahiro Ono, Felix Hinz, Masataka Takahashi, Yuko Hiroshima, Koya Kodama, Michihiro Yano, Hiroshi Nanjo, Tsutomu Takahashi, Andreas von Deimling, Hiroaki Shimizu
Journal of neurosurgery. Case lessons ( Journal of Neurosurgery: Case Lessons ) 6 ( 1 ) 2023年07月 [査読有り]
研究論文（学術雑誌） 国際共著
BACKGROUND: The etiological significance of the RAS and PI3K pathways has been reported in systemic embryonal rhabdomyosarcoma (ERMS) but not in primary intracranial ERMS (PIERMS). Herein, the authors present a unique case of PIERMS with a BRAF mutation. OBSERVATIONS: A 12-year-old girl with progressive headache and nausea was diagnosed with a tumor in the right parietal lobe. Semi-emergency surgery revealed an intra-axial lesion that was histopathologically identical to an ERMS. Next-generation sequencing indicated a BRAF mutation as a pathogenic variation, but the RAS and PI3K pathways showed no alteration. Although there is no established reference class for PIERMS, the DNA methylation prediction was closest to that of ERMS, indicating the possibility of PIERMS. The final diagnosis was PIERMS. The patient underwent local radiotherapy (50.4 Gy) and multiagent chemotherapy, with no recurrence for 12 months after surgery. LESSONS: This may be the first case demonstrating the molecular features of PIERMS, especially the intra-axial type. The results showed a mutation in BRAF but not in the RAS and PI3K pathways, which is different from the existing ERMS features. This molecular difference may cause differences in DNA methylation profiles. Accumulation of the molecular features of PIERMS is necessary before any conclusions can be drawn.
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急性硬膜下血腫の保存的初期治療症例に関する検討
桑山 実喜子, 小野 隆裕, 富樫 俊太郎, 髙橋 和孝, 清水 宏明
神経外傷 ( 一般社団法人 日本脳神経外傷学会 ) 46 ( 1 ) 12 - 19 2023年06月 [査読有り]
研究論文（学術雑誌） 国内共著
Although the surgical indication of acute subdural hematoma (ASDH) is described in guidelines, outcomes of initial conservative management have not been investigated in detail. The purpose of the present study was to clarify frequency and causes of neurological aggravation during initial conservative management for ASDH.
Patients with ASDH treated at the Akita University Hospital between April 2014 and September 2022 were reviewed retrospectively. Patients who received initial conservative management because of non–severe neurological deficits were divided into two groups; with or without further neurological aggravation. Risk factors, reasons of the aggravation, treatment after the aggravation and clinical outcomes were analyzed.
In a total of 73 patients with ASDH, 58 (79.5%) patients were initially managed conservatively. Among 42 non–severe cases, 30 (71.4%) patients had no further neurological aggravation. Twelve (28.6%) patients with neurological aggravation (between day 1 – 11) had significantly thicker initial ASDHs and lower Glasgow Coma Scales at discharge than those without aggravation. The causes of the aggravation included hematoma enlargement and seizure in 2 cases each, systemic complications in 1, and others in 7 cases. In the last 7 cases, hyperintensity lesions in the cerebral cortex adjacent to the hematoma on arterial spin labelling (ASL) images were observed in 6 cases and abnormal electroencephalography (EEG) findings (spike–and–waves or slow waves) in 3 cases. In four of these 7 cases, hematoma removal was performed resulting in improving their clinical symptoms.
In conclusion, in patients with ASDH who were initially managed conservatively due to non–severe neurological deficits, further aggravation was observed in 12 (28.6%). Six (50.0%) of these showed ASL and/or EEG findings that may not contradict non–convulsive seizures. To clarify the causes of neurological aggravation during initial conservative management more precisely, further investigation employing continuous EEG will be expected. -
Ryota Kurogi, Akiko Kada, Kuniaki Ogasawara, Kunihiro Nishimura, Takanari Kitazono, Toru Iwama, Yuji Matsumaru, Nobuyuki Sakai, Yoshiaki Shiokawa, Shigeru Miyachi, Satoshi Kuroda, Hiroaki Shimizu, Shinichi Yoshimura, Toshiaki Osato, Nobutaka Horie, Izumi Nagata, Kazuhiko Nozaki, Isao Date, Yoichiro Hashimoto, Haruhiko Hoshino, Hiroyuki Nakase, Hiroharu Kataoka, Tsuyoshi Ohta, Hitoshi Fukuda, Nanako Tamiya, A I Kurogi, Nice Ren, Ataru Nishimura, Koichi Arimura, Takafumi Shimogawa, Koji Yoshimoto, Daisuke Onozuka, Soshiro Ogata, Akihito Hagihara, Nobuhito Saito, Hajime Arai, Susumu Miyamoto, Teiji Tominaga, Koji Iihara; J-ASPECT Study Collaborators
BMJ open ( BMJ open ) 13 ( 4 ) 2023年04月 [査読有り]
研究論文（学術雑誌） 国内共著
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12 年の経過で悪性転化した星細胞腫における，病理・分子生物学的変化: 症例報告
高木 いさん, 小野 隆裕, 髙橋 和孝, 清水 宏明
秋田医学 ( 秋田医学会 ) 49 ( 3/4 ) 131 - 138 2023年03月 [査読有り]
研究論文（学術雑誌） 国内共著
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Hiroaki Shimizu, Takahiro Ono, Takatsugu Abe, Masaaki Hokari, Yusuke Egashira, Koji Shimonaga, Masahiko Kawanishi, Kyoko Nomura, Yusuke Takahashi
Neurologia medico-chirurgica ( Neurologia Medico-Chirurgica ) 63 ( 2 ) 80 - 89 2023年01月 [査読有り]
研究論文（学術雑誌） 国内共著
Intracranial carotid artery dissection causing cerebral ischemia is a rare but important cause of cerebral infarction in children and adolescents. Although endovascular therapy has been reported to be effective, questions regarding the indications for intervention are yet to be addressed. Therefore, this study aimed to evaluate factors related to clinical outcomes through a nationwide survey. Overall, 35 neurosurgical centers reported patients within 2 weeks after ischemic onset due to intracranial carotid artery dissection causing cerebral ischemia treated between January 2015 and December 2020. Data on clinical and radiological findings were statistically analyzed. Twenty-eight patients met the inclusion criteria. The median age was 36 years (range, 7-59 years), without sex differences. Headache at onset was documented in 60.7% of the patients. Dissection findings were categorized into stenosis (71.4%) or occlusion (28.6%). Initial treatments, including various antithrombotic agent combinations in 23 (82.1%) patients, effectively improved or prevented aggravation in half of the patients. The patients with stenotic dissection were significantly more likely to experience aggravation during the initial treatment than did those with occlusive dissection (P = 0.03). In addition, the patients with moderate to severe neurological deficits on admission had poorer outcomes at discharge more frequently than did those with mild neurological deficits on admission. Eight patients undergoing endovascular therapy had no procedural complications or further aggravation after intervention. In conclusion, patients with intracranial carotid dissection causing cerebral ischemia who had a stenotic dissection were at risk of further aggravation, and endovascular therapy effectively improved or prevented aggravation.
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Complex Intracranial Aneurysms.
Shuntaro Togashi, Hiroaki Shimizu
Advances and technical standards in neurosurgery ( Advances and technical standards in neurosurgery ) 44 225 - 238 2022年
総説・解説（商業誌） 国内共著
Complex intracranial aneurysms remain challenging to treat using standard microsurgical or endovascular techniques. These aneurysms often require a combination of deconstructive and reconstructive procedures, such as parent artery occlusion, flow alteration, and blind-alley formation with or without bypass surgery, for effective and enduring therapeutic effects. It is important to determine the type of bypass based on the site of occlusion of the patent artery, anatomical features of the distal vessels, and expected adequate blood flow. In this chapter, we describe the "Standards," "Advances," and "Controversies" in the context of a microsurgical treatment strategy for complex intracranial aneurysms. "Standards" include a combination of frequent and commonly used procedures that have been gathering a certain consensus on their effectiveness. "Advances" include infrequent, demanding, and/or uncertain surgical procedures that are currently under debate. Finally, "Controversies" discuss a number of unsolved issues.
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神経救急 : 急性期脳梗塞を中心とした最近の話題とpitfall回避
清水 宏明
秋田県医師会雑誌 = Akita medical journal ( 秋田県医師会 ) 68 ( 1 ) 1 - 5 2018年01月
研究論文（大学，研究機関紀要） 単著
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もやもや病に対するバイパス術の周術期の問題点
工藤 絵里奈, 柳澤 俊晴, 清水 宏明
東北脳血管障害研究会学術集会記録集 ( サノフィ(株)仙台オフィス ) 40回 0144 - 0160 2018年12月
研究論文（研究会，シンポジウム資料等） 国内共著
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伊藤 裕太, 長縄 明大, 小松 和三, 関 健史, 平澤 富士子, 高橋 和孝, 清水 宏明
日本機械学会東北支部秋季講演会講演論文集 ( 一般社団法人 日本機械学会 ) 2018 ( 0 ) 2018年
研究論文（研究会，シンポジウム資料等） 国内共著
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Complex Intracranial Aneurysms
Togashi S、Shimizu H.
Advances and technical standards in neurosurgery ( Advances and technical standards in neurosurgery ) 44 225 - 238 2022年 [招待有り]
国内共著
Complex intracranial aneurysms remain challenging to treat using standard microsurgical or endovascular techniques. These aneurysms often require a combination of deconstructive and reconstructive procedures, such as parent artery occlusion, flow alteration, and blind-alley formation with or without bypass surgery, for effective and enduring therapeutic effects. It is important to determine the type of bypass based on the site of occlusion of the patent artery, anatomical features of the distal vessels, and expected adequate blood flow. In this chapter, we describe the "Standards," "Advances," and "Controversies" in the context of a microsurgical treatment strategy for complex intracranial aneurysms. "Standards" include a combination of frequent and commonly used procedures that have been gathering a certain consensus on their effectiveness. "Advances" include infrequent, demanding, and/or uncertain surgical procedures that are currently under debate. Finally, "Controversies" discuss a number of unsolved issues.
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東北・新潟地区における高齢者悪性リンパ腫の臨床病理学的予後因子の検討-東北脳腫瘍研究会共同研究-
浅野研一郎, 山下洋二, 小野隆裕, 棗田学, 別府高明, 松田憲一朗, 市川優寛, 金森政之, 麓敏雄, 松坂方士, 黒瀬顕, 齋藤清, 園田順彦, 小笠原邦昭, 藤井幸彦, 清水宏明, 大熊洋揮, 北中千史, 嘉山孝正, 冨永悌二
Brain Tumor Pathology (Web) 38 ( Supplement ) 2021年
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脳腫瘍術後てんかんの診断におけるarterial spin labelingの有用性
小野隆裕, 高橋和孝, 清水宏明
日本脳神経CI学会総会プログラム・抄録集(Web) 44th 2021年
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視神経・視交叉に接触する非機能性下垂体腺腫に対する寡分割定位放射線治療の長期成績
畠愛子, 小田正哉, 高橋和孝, 小野隆裕, 清水宏明
日本脳神経CI学会総会プログラム・抄録集(Web) 44th 2021年
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遺残三叉動脈瘤破裂によりCarotid-Cavernous Sinus Fistulaをきたした1例
國分 康平, 師井 淳太, 吉田 泰之, 大久保 敦也, 引地 堅太郎, 古谷 伸春, 吉川 剛平, 石川 達哉, 清水 宏明
脳血管内治療 ( (NPO)日本脳神経血管内治療学会 ) 5 ( Suppl. ) 68 - 68 2020年11月
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井川 房夫, 黒田 敏, 清水 宏明, 冨永 悌二 ( 担当： その他 )
メジカルビュー社 2020年 ISBN: 9784758318525
科研費（文科省・学振）獲得実績 【 表示 ／ 非表示 】
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局所慢性脳低灌流モデルの開発と血行再建後過灌流機序の解明
基盤研究(C)
研究期間: 2022年04月 - 2025年03月 代表者: 清水 宏明, 板東 良雄, 渡邊 博之, 阿部 考貢
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局所慢性脳低灌流モデルの開発と血行再建後過灌流機序の解明
基盤研究(C)
研究期間: 2022年04月 - 2025年03月 代表者: 清水 宏明, 板東 良雄, 渡邊 博之, 阿部 考貢
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新規慢性脳虚血および脳血管内皮機能障害モデルの開発と血流再建後過灌流機序の解明
基盤研究(C)
研究期間: 2018年04月 - 2021年03月 代表者: 清水 宏明, 新妻 邦泰
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新規慢性脳虚血および脳血管内皮機能障害モデルの開発と血流再建後過灌流機序の解明
基盤研究(C)
研究期間: 2018年04月 - 2021年03月 代表者: 清水 宏明, 新妻 邦泰
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数値流体力学解析に基づく脳動静脈奇形の血流解析と集学的治療への応用
基盤研究(B)
研究期間: 2014年04月 - 2017年03月 代表者: 清水 宏明, 冨永 悌二, 新妻 邦泰, 杉山 慎一郎, 鷲尾 利克, 大田 英揮, 荒船 龍彦, 船本 健一
学会・委員会等活動 【 表示 ／ 非表示 】
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日本脳神経外科学会
2021年10月-継続中理事
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日本脳卒の外科学会
2019年04月-継続中理事
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日本脳卒中学会
2014年04月-継続中幹事
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日本脳神経外科学会
2014年04月-継続中理事、代議員、専門医認定委員、研究倫理審査委員等
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日本脳神経外科学会
2010年04月-継続中代議員 各種委員会委員