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附属病院 脳神経外科 |
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2023年04月-継続中
秋田大学 附属病院 脳神経外科 講師
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2017年07月-2023年03月
秋田大学 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 助教
職務経歴（学外） 【 表示 ／ 非表示 】
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2023年04月-継続中
秋田大学大学院 脳神経外科 講師
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2017年07月-継続中
秋田大学大学院 脳神経外科 助教
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2015年11月-2017年06月
ハイデルベルク大学神経 神経病理学研究室 客員研究員
研究経歴 【 表示 ／ 非表示 】
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IDH-wildtype gliomaにおける悪性化機構の解明
科学研究費補助金
研究期間：
2019年04月-継続中研究態様：個人研究
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IDHミュータント神経膠腫の病理分類と 悪性度に関する研究
国際共同研究
研究期間：
2015年11月-2017年10月研究態様：国際共同研究
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テモゾロミド耐性悪性グリオーマに対するインターフェロンβ，ベバシズマブ併用テモゾロミド療法におけるアミノ酸トレーサを用いた効果判定の重要性
科学研究費補助金
研究期間：
2011年04月-2015年03月研究態様：国内共同研究
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Takahiro Ono, Hayato Suzuki, Hiroshi Nanjo, Hiroaki Shimizu
Journal of neuro-oncology ( Journal of Neuro-Oncology ) 168 ( 3 ) 393 - 404 2024年05月 [査読有り]
研究論文（学術雑誌）
PURPOSE: It remains unclear whether combining carmustine wafer (CW) implantation with the standard treatment for adult-type diffuse gliomas is safe and has a prognostic impact. This study aimed to investigate the prognostic value and safety of CW implantation. METHODS: Adult patients with IDH-wild-type and -mutant gliomas, grades 3-4 treated with surgical resection, radiotherapy, and temozolomide chemotherapy between 2013 and 2023 were surveyed. CWs were implanted except in cases of intraoperative wide ventricle opening or marked preoperative brain swelling. For survival analyses, a case-matched dataset based on propensity score matching (PSM), including multiple factors (patient background, diagnosis, and extent of resection) was generated. Progression-free survival (PFS), overall survival (OS), and frequency of complications of CW implantation (brain edema, infection, and cerebrospinal fluid leakage) were compared between the CW and non-use groups. RESULTS: In total, 127 patients (75 in the CW use group and 52 in the non-use group) were enrolled. Regardless of stratification, no significant differences in PFS and OS were observed between the CW use and non-use groups. The frequency of postoperative brain edema was significantly higher in the CW use group than in the non-use group. An adjusted dataset containing 41 patients in the CW use and nonuse groups was generated. Even after PSM, CW implantation had no prognostic effect. CONCLUSIONS: CW implantation with standard treatment demonstrated little beneficial effect for the present strategy of CW use.
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Takahashi Yusuke, Ono Takahiro, Moroi Junta, Maruya Jun, Togashi Shuntaro, Abe Takatsugu, Nakae Hajime, Fujita Yasuo, Takahashi Shinichi, Shimizu Hiroaki
脳神経血管内治療 ( 日本脳神経血管内治療学会 ) advpub ( 0 ) 103 - 109 2024年 [査読有り]
研究論文（学術雑誌）
<p><b>Objective:</b> Early intervention with mechanical thrombectomy (MT) is expected to improve the functional outcome in patients with large vessel occlusion (LVO); however, a method for the effective detection of these patients in a prehospital setting and early transport to MT-capable hospitals has not been established. This study aimed to analyze the clinical impact and diagnostic performance of the emergent large vessel occlusion (ELVO) screen and its influence on the transportation time.</p><p><b>Methods:</b> The emergency medical services (EMS) in one of the secondary medical areas in Akita, Japan, introduced a prehospital triage system employing an ELVO screen and a rotation system of three MT-capable hospitals on December 1, 2021. Patients who were transferred to each of the three hospitals involved in the rotation system according to a predefined priority list from December 2021 to November 2022 were included in the triage group. Patients who underwent MT in the three hospitals before the introduction of the triage system were assigned to the pre-triage group. We compared the transportation time parameters between the two groups and analyzed the performance of the ELVO screen for the diagnosis of LVOs. This study was approved by the institutional review boards of all three hospitals.</p><p><b>Results:</b> Time parameters were compared between the 37 and 42 patients who underwent MT and had detailed data in the triage (n = 351) and pre-triage (n = 43) groups, respectively. The time from door to puncture tended to decrease in the triage group in all hospitals, with one hospital showing a statistically significant shortening of 14 min (p = 0.018). In the triage group, 209 ELVO screen-positive patients were present, with 60 (28.7%) of these having LVO. The sensitivity, specificity, positive and negative predictive values, and area under the curve of the ELVO screen to detect LVO under the present triage system were 87.0%, 47.2%, 28.7%, 93.7%, and 0.671, respectively.</p><p><b>Conclusion:</b> The present study demonstrated that the introduction of a triage system may have shortened the time required for MT. ELVO screen may be considered a useful marker for screening LVO in prehospital settings in terms of the sensitivity and negative predictive value; however, further improvement may be necessary to reduce the rate of false positive results.</p>
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Mamatjan Y.
Neuro-Oncology ( Neuro-Oncology ) 25 ( 11 ) 2028 - 2041 2023年11月 [査読有り]
研究論文（学術雑誌）
BACKGROUND: Diffuse gliomas represent over 80% of malignant brain tumors ranging from low-grade to aggressive high-grade lesions. Within IDH-mutant gliomas there is a high variability in survival and a need to more accurately predict outcome. METHODS: To identify and characterize a predictive signature of outcome in gliomas, we utilized an integrative molecular analysis (using methylation, mRNA, copy number variation (CNV) and mutation data), analyzing a total of 729 IDH-mutant samples including a test set of 99 from University Health Network (UHN) and two validation cohorts including the German Cancer Research Center (DKFZ) and The Cancer Genome Atlas (TCGA). RESULTS: Cox regression analysis of methylation data from the UHN cohort identified CpG-based signatures that split the glioma cohort into two prognostic groups strongly predicting survival that were validated using two independent cohorts from TCGA and DKFZ (all p-values<0.0001). The methylation signatures that predicted poor outcome also exhibited high CNV instability and hypermethylation of HOX gene probes. Integrated multi-platform analyses using mRNA and methylation (iRM) showed that parallel HOX gene overexpression and simultaneous hypermethylation were significantly associated with increased mutational load, high aneuploidy and worse survival (p-value<0.0001). A 7-HOX gene signature was developed and validated using the most significantly associated HOX genes with patient outcome in both 1p/19q codeleted and non-codeleted IDHmut gliomas. CONCLUSIONS: HOX gene methylation and expression provide important prognostic information in IDH-mutant gliomas that are not captured by current molecular diagnostics. A 7-HOX gene signature of outcome shows significant survival differences in both 1p/19q codeleted and non-codeleted IDH-mutant gliomas.
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SHIMIZU Hiroaki, ONO Takahiro, ABE Takatsugu, HOKARI Masaaki, EGASHIRA Yusuke, SHIMONAGA Koji, KAWANISHI Masahiko, NOMURA Kyoko, TAKAHASHI Yusuke
Neurologia medico-chirurgica ( 一般社団法人 日本脳神経外科学会 ) advpub ( 0 ) 80 - 89 2023年 [査読有り]
研究論文（学術雑誌）
<p>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 (<i>P</i> = 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.</p>
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Abe M.
Journal of Neurosurgery: Case Lessons ( Journal of Neurosurgery: Case Lessons ) 6 ( 1 ) 2023年 [査読有り]
研究論文（学術雑誌）
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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内科医が知っておくべき脳出血の急性期治療
小野隆裕，清水宏明
Medicina ( 医学書院 ) 2016年02月
総説・解説（商業誌） 国内共著
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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]
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. -
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, 高橋 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]
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間接血行再建術後に対側脳血流の改善がみられた成人もやもや病の1例
富樫 俊太郎, 木村 早希, 阿部 真道, 高橋 佑介, 小野 隆裕, 高橋 和孝, 清水 宏明
脳循環代謝 ( (一社)日本脳循環代謝学会 ) 34 ( 1 ) 140 - 140 2022年10月
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R-IHCの自動化に向けて-病理医の立場から-
南條博, 廣嶋優子, 今井一博, 寺田かおり, 小野隆裕, 中村竜太, 大久保義真, 赤上陽一, 南谷佳弘
日本病理学会会誌 110 ( 1 ) 2021年
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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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第33回山下太郎学術研究奨励賞
2022年06月01日 一般財団法人山下太郎顕彰育英会 病理学および分子生物学的解析を統合した、悪性髄内腫瘍の診断の最適化
受賞者： 小野隆裕
科研費（文科省・学振）獲得実績 【 表示 ／ 非表示 】
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テクスチャ解析と分子解析に基づく、gliomaの病理診断法の刷新
基盤研究(C)
研究期間: 2024年04月 - 2029年03月 代表者: 小野 隆裕
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IDH-wildtype gliomaにおける悪性化機構の解明
若手研究
研究期間: 2019年04月 - 2023年03月 代表者: 小野 隆裕
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IDH-wildtype gliomaにおける悪性化機構の解明
若手研究
研究期間: 2019年04月 - 2023年03月 代表者: 小野 隆裕