Faculty Profiles - akihide Tanimoto

Papers - akihide Tanimoto

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Jun Kaminosono, Yuki Kambe, Akihide Tanimoto, Tomoyuki Kuwaki, Akira Yamashita . The physiological response during optogenetic-based cardiac pacing in awake freely moving mice. . Frontiers in physiology14 1130956 - 1130956 2023Reviewed International journal

Language：English Publishing type：Research paper (scientific journal)

There are several methods to control a heart rate, such as electrical stimulation and drug administration. However, these methods may be invasive or affect other organs. Recently, an optogenetic-based cardiac pacing method has enabled us to stimulate the cardiac muscle in non-contact. In many previous studies, the pacing was applied ex vivo or in anesthetized animals. Therefore, the physiologic response of animals during optogenetic pacing remains unclear. Here, we established a method of optogenetic-based cardiac pacing in awake, freely moving mice and simultaneously measured electrocardiogram, blood pressure, and respiration. As a result, light-induced myocardial contraction produces blood flow and indirectly affects the respiration rhythm. Additionally, light illumination enabled heart rate recovery in bradycardic mice. These findings may be employed for further research that relates a heartbeat state to animal behavior. Together, this method may drive the development of less invasive pacemakers without pacing leads.

DOI： 10.3389/fphys.2023.1130956

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Ryutaro Makino, Nayuta Higa, Toshiaki Akahane, Hajime Yonezawa, Hiroyuki Uchida, Tomoko Takajo, Shingo Fujio, Mari Kirishima, Taiji Hamada, Hitoshi Yamahata, Kiyohisa Kamimura, Takashi Yoshiura, Koji Yoshimoto, Akihide Tanimoto, Ryosuke Hanaya . Alterations in EGFR and PDGFRA are associated with the localization of contrast-enhancing lesions in glioblastoma. . Neuro-oncology advances5 ( 1 ) vdad110 2023Reviewed International journal

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Glioblastoma (GBM) is a malignant brain tumor, with radiological and genetic heterogeneity. We examined the association between radiological characteristics and driver gene alterations. METHODS: We analyzed the driver genes of 124 patients with IDH wild-type GBM with contrast enhancement using magnetic resonance imaging. We used a next-generation sequencing panel to identify mutations in driver genes and matched them with radiological information. Contrast-enhancing lesion localization of GBMs was classified into 4 groups based on their relationship with the subventricular zone (SVZ) and cortex (Ctx). RESULTS: The cohort included 69 men (55.6%) and 55 women (44.4%) with a mean age of 66.4 ± 13.3 years. EGFR and PDGFRA alterations were detected in 28.2% and 22.6% of the patients, respectively. Contrast-enhancing lesion touching both the SVZ and Ctx was excluded because it was difficult to determine whether it originated from the SVZ or Ctx. Contrast-enhancing lesions touching the SVZ but not the Ctx had significantly worse overall survival than non-SVZ lesions (441 days vs. 897 days, P = .002). GBM touching only the Ctx had a better prognosis (901 days vs. 473 days, P < .001) than non-Ctx lesions and was associated with EGFR alteration (39.4% vs. 13.2%, P = .015). Multiple contrast lesions were predominant in PDGFRA alteration and RB1-wild type (P = .036 and P = .031, respectively). CONCLUSIONS: EGFR alteration was associated with cortical lesions. And PDGFRA alteration correlated with multiple lesions. Our results suggest that clarifying the association between driver genes and tumor localization may be useful in clinical practice, including prognosis prediction.

DOI： 10.1093/noajnl/vdad110

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Nayuta Higa, Toshiaki Akahane, Seiya Yokoyama, Ryutaro Makino, Hajime Yonezawa, Hiroyuki Uchida, Tomoko Takajo, Mari Kirishima, Taiji Hamada, Naoki Noguchi, Ryosuke Otsuji, Daisuke Kuga, Shohei Nagasaka, Hitoshi Yamahata, Junkoh Yamamoto, Koji Yoshimoto, Akihide Tanimoto, Ryosuke Hanaya . Favorable prognostic impact of phosphatase and tensin homolog alterations in wild-type isocitrate dehydrogenase and telomerase reverse transcriptase promoter glioblastoma. . Neuro-oncology advances5 ( 1 ) vdad078 2023Reviewed International journal

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Telomerase reverse transcriptase promoter (TERTp) mutations are a biological marker of glioblastoma; however, the prognostic significance of TERTp mutational status is controversial. We evaluated this impact by retrospectively analyzing the outcomes of patients with isocitrate dehydrogenase (IDH)- and TERTp-wild-type glioblastomas. METHODS: Using custom next-generation sequencing, we analyzed 208 glioblastoma samples harboring wild-type IDH. RESULTS: TERTp mutations were detected in 143 samples (68.8%). The remaining 65 (31.2%) were TERTp-wild-type. Among the TERTp-wild-type glioblastoma samples, we observed a significant difference in median progression-free survival (18.6 and 11.4 months, respectively) and overall survival (not reached and 15.7 months, respectively) in patients with and without phosphatase and tensin homolog (PTEN) loss and/or mutation. Patients with TERTp-wild-type glioblastomas with PTEN loss and/or mutation were younger and had higher Karnofsky Performance Status scores than those without PTEN loss and/or mutation. We divided the patients with TERTp-wild-type into 3 clusters using unsupervised hierarchical clustering: Good (PTEN and TP53 alterations; lack of CDKN2A/B homozygous deletion and platelet-derived growth factor receptor alpha (PDGFRA) alterations), intermediate (PTEN alterations, CDKN2A/B homozygous deletion, lack of PDGFRA, and TP53 alterations), and poor (PDGFRA and TP53 alterations, CDKN2A/B homozygous deletion, and lack of PTEN alterations) outcomes. Kaplan-Meier survival analysis indicated that these clusters significantly correlated with the overall survival of TERTp-wild-type glioblastoma patients. CONCLUSIONS: Here, we report that PTEN loss and/or mutation is the most useful marker for predicting favorable outcomes in patients with IDH- and TERTp-wild-type glioblastomas. The combination of 4 genes, PTEN, TP53, CDKN2A/B, and PDGFRA, is important for the molecular classification and individual prognosis of patients with IDH- and TERTp-wild-type glioblastomas.

DOI： 10.1093/noajnl/vdad078

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Kazuyasu Fujii, Mari Kirishima, Makoto Yoshimitsu, Takaki Hashiguchi, Akihide Tanimoto, Takuro Kanekura . Adult T-cell leukemia/lymphoma presenting with ulceration of the digits. . The Journal of dermatology50 ( 5 ) e168 - e170 2022.12Reviewed International journal

Taiji Hamada, Seiya Yokoyama, Toshiaki Akahane, Kei Matsuo, Akihide Tanimoto . Genome Editing Using Cas9 Ribonucleoprotein Is Effective for Introducing PDGFRA Variant in Cultured Human Glioblastoma Cell Lines. . International journal of molecular sciences24 ( 1 ) 2022.12Reviewed International journal

Language：English Publishing type：Research paper (scientific journal)

Many variants of uncertain significance (VUS) have been detected in clinical cancer cases using next-generation sequencing-based cancer gene panel analysis. One strategy for the elucidation of VUS is the functional analysis of cultured cancer cell lines that harbor targeted gene variants using genome editing. Genome editing is a powerful tool for creating desired gene alterations in cultured cancer cell lines. However, the efficiency of genome editing varies substantially among cell lines of interest. We performed comparative studies to determine the optimal editing conditions for the introduction of platelet-derived growth factor receptor alpha (PDGFRA) variants in human glioblastoma multiforme (GBM) cell lines. After monitoring the copy numbers of PDGFRA and the expression level of the PDGFRα protein, four GBM cell lines (U-251 MG, KNS-42, SF126, and YKG-1 cells) were selected for the study. To compare the editing efficiency in these GBM cell lines, the modes of clustered regularly interspaced short palindromic repeat (CRISPR)-associated protein 9 (Cas9) delivery (plasmid vs. ribonucleoprotein (RNP)), methods of transfection (lipofection vs. electroporation), and usefulness of cell sorting were then evaluated. Herein, we demonstrated that electroporation-mediated transfer of Cas9 with single-guide RNA (Cas9 RNP complex) could sufficiently edit a target nucleotide substitution, irrespective of cell sorting. As the Cas9 RNP complex method showed a higher editing efficiency than the Cas9 plasmid lipofection method, it was the optimal method for single-nucleotide editing in human GBM cell lines under our experimental conditions.

DOI： 10.3390/ijms24010500

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Tatsuhiko Furukawa, Sho Tabata, Kentaro Minami, Masatatsu Yamamoto, Kohichi Kawahara, Akihide Tanimoto . Metabolic reprograming of cancer as a therapeutic target. . Biochimica et biophysica acta. General subjects1867 ( 3 ) 130301 - 130301 2022.12Reviewed International journal

Language：English Publishing type：Research paper (scientific journal)

Our understanding of metabolic reprogramming in cancer has tremendously improved along with the technical progression of metabolomic analysis. Metabolic changes in cancer cells proved much more complicated than the classical Warburg effect. Previous studies have approached metabolic changes as therapeutic and/or chemopreventive targets. Recently, several clinical trials have reported anti-cancer agents associated with metabolism. However, whether cancer cells are dependent on metabolic reprogramming or favor suitable conditions remains nebulous. Both scenarios are possibly intertwined. Identification of downstream molecules and the understanding of mechanisms underlying reprogrammed metabolism can improve the effectiveness of cancer therapy. Here, we review several examples of the metabolic reprogramming of cancer cells and the therapies targeting the metabolism-related molecules as well as discuss practical approaches to improve the next generation of cancer therapies focused on the metabolic reprogramming of cancer.

DOI： 10.1016/j.bbagen.2022.130301

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Jun Nagahama, Takuro Nishikawa, Takashi Tasaki, Yuki Yasudome, Tatsuro Nakamura, Takanari Abematsu, Shunsuke Nakagawa, Yuichi Kodama, Akihide Tanimoto, Yasuhiro Okamoto . Systemic Epstein-Barr virus-positive T-cell lymphoma of childhood treated with the ICE regimen and allogeneic hematopoietic stem-cell transplantation. . Pediatric blood & cancer70 ( 3 ) e30041 2022.10Reviewed International journal

Mari Kirishima, Toshiaki Akahane, Nayuta Higa, Shinsuke Suzuki, Shinichi Ueno, Hajime Yonezawa, Hiroyuki Uchida, Ryosuke Hanaya, Koji Yoshimoto, Shohei Shimajiri, Ikumi Kitazono, Akihide Tanimoto . IDH-mutant astrocytoma with an evolutional progression to CDKN2A/B homozygous deletion and NTRK fusion during recurrence: A case report. . Pathology, research and practice239 154163 - 154163 2022.10Reviewed International journal

Language：English

We reported a case of molecularly defined isocitrate dehydrogenase (IDH)-mutant astrocytoma that recurred twice with aggressive behavior and increased anaplastic morphology. Primary and recurrent tumors were analyzed using custom-made DNA-based cancer gene and RNA-based fusion panels for next-generation sequencing (NGS). NGS analyses revealed that recurrent astrocytoma, in addition to IDH1 and tumor protein 53 mutations detected in the primary lesion, harbored cyclin-dependent kinase inhibitor (CDKN) 2 A/B homozygous deletion and neurotrophic tropomyosin receptor kinase 2 (NTRK2) fusion genes that consisted of golgin A1- and cyclin-dependent kinase 5 regulatory subunit associated protein 2-NTRK2 fusions. Anaplasia and necrosis were observed in the recurrent tumors, but not in the primary lesion. Therefore, the integrative diagnosis was primary IDH-mutant astrocytoma grade 2 and recurrent IDH-mutant astrocytoma grade 4 with NTRK2 fusions. This is a worthwhile report describing a case of IDH-mutant astrocytoma that showed genomic evolution during tumor recurrence. Our report suggests that NTRK fusion and CDKN2A/B homozygous deletion promote high-grade transformation and indicate an unfavorable prognosis of IDH-mutant astrocytoma.

DOI： 10.1016/j.prp.2022.154163

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北薗育美, 霧島茉莉, 田崎貴嗣, 田畑和宏, 東美智代, 野口紘嗣, 簗詰伸太郎, 神宮司メグミ, 谷本昭英 . FDG-PET高集積を示した遺残副腎由来のOncocytomaの1例 . 診断病理39 ( 4 ) 319 - 325 2022.10Reviewed

Language：Japanese Publisher：(一社)日本病理学会

遺残副腎は異所性に認められる副腎皮質組織であり,腫瘍化は非常に稀である。80代女性の骨盤腔内にFDGの高集積を呈する腫瘍を認めた。腫瘍は右子宮広間膜内に卵巣とは離れて存在し,好酸性顆粒状の豊富な細胞質を有する腫瘍細胞のびまん性増殖からなり,腫瘍辺縁には非腫瘍性の副腎皮質組織を伴っていた。免疫染色でSF-1,mitochondria陽性であった。Lin-Weiss-Bisceglia criteriaを満たす所見はなく,遺残副腎由来のoncocytomaと診断した。(著者抄録)

Higa Nayuta, Akahane Toshiaki, Yokoyama Seiya, Yonezawa Hajime, Uchida Hiroyuki, Fujio Shingo, Kirishima Mari, Takigawa Kosuke, Hata Nobuhiro, Toh Keita, Yamamoto Junkoh, Hanaya Ryosuke, Tanimoto Akihide, Yoshimoto Koji . Molecular Genetic Profile of 300 Japanese Patients with Diffuse Gliomas Using a Glioma-tailored Gene Panel(タイトル和訳中) . Neurologia medico-chirurgica62 ( 9 ) 391 - 399 2022.9Reviewed

Language：English Publisher：(一社)日本脳神経外科学会

日本人患者のびまん性神経膠腫にみられる、分子遺伝学的プロファイルについて調査した。著者等の大学で収集した、びまん性神経膠腫患者303例の腫瘍組織試料を用いて、神経膠腫に特化した遺伝子パネルから、分子遺伝学的プロファイルを解析した。その結果、膠芽腫(GBM)患者185例に最も変異が多く認められた遺伝子は、TERTp遺伝子、TP53遺伝子、PTEN遺伝子、NF1遺伝子とPDGFRA遺伝子であった。また、欠失が最も多く認められた遺伝子は、PTEN遺伝子およびCDKN2A/B及びRB1遺伝子で、増加/増幅が最も多く認められた遺伝子は、EGFR遺伝子とPDGFRA遺伝子およびCDK4遺伝子であった。さらに、グレードIII乏突起膠腫22例のうち3例には、CDKN2A/B遺伝子のホモ接合性欠失が、4例にはARID1A遺伝子変異が検出され、ARID1A遺伝子変異が無増悪生存転帰不良と関連することが示唆された。なお、WHO脳腫瘍分類2021により、グレードII/IIIでIDH野生型星状細胞腫の62.5%が、IDH野生型のGBMに再分類された。本報により、神経膠腫に特化した遺伝子パネルが、WHO脳腫瘍分類2021に準じた分子診断に適用可能であることが確認された。

Nayuta Higa, Toshiaki Akahane, Seiya Yokoyama, Hajime Yonezawa, Hiroyuki Uchida, Shingo Fujio, Mari Kirishima, Kosuke Takigawa, Nobuhiro Hata, Keita Toh, Junkoh Yamamoto, Ryosuke Hanaya, Akihide Tanimoto, Koji Yoshimoto . Molecular Genetic Profile of 300 Japanese Patients with Diffuse Gliomas Using a Glioma-tailored Gene Panel. . Neurologia medico-chirurgica62 ( 9 ) 391 - 399 2022.8Reviewed

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japan Neurosurgical Society

Rapid technological advances in molecular biology, including next-generation sequencing, have identified key genetic alterations in central nervous system (CNS) tumors. Accordingly, the fifth edition of the World Health Organization (WHO) CNS tumor classification was published in 2021. We analyzed 303 patients with diffuse glioma using an amplicon-based glioma-tailored gene panel for detecting 1p/19q codeletion and driver gene mutations such as IDH1/2, TERTp, EGFR, and CDKN2A/B on a single platform. Within glioblastomas (GBMs), the most commonly mutated genes were TERTp, TP53, PTEN, NF1, and PDGFRA, which was the most frequently mutated tyrosine kinase receptor in GBM, followed by EGFR. The genes that most commonly showed evidence of loss were PTEN, CDKN2A/B, and RB1, whereas the genes that most commonly showed evidence of gain/amplification were EGFR, PDGFRA, and CDK4. In 22 grade III oligodendroglial tumors, 3 (14%) patients had CDKN2A/B homozygous deletion, and 4 (18%) patients had ARID1A mutation. In grade III oligodendroglial tumors, an ARID1A mutation was associated with worse progression-free survival. Reclassification based on the WHO 2021 classification resulted in 62.5% of grade II/III isocitrate dehydrogenase (IDH) -wildtype astrocytomas being classified as IDH-wildtype GBM and 37.5% as not elsewhere classified. In summary, our glioma-tailored gene panel was applicable for molecular diagnosis in the WHO 2021 classification. In addition, we successfully reclassified the 303 diffuse glioma cases based on the WHO 2021 classification and clarified the genetic profile of diffuse gliomas in the Japanese population.

DOI： 10.2176/jns-nmc.2022-0103

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Sieya Yokoyama, Hiromichi Iwaya, Toshiaki Akahane, Taiji Hamada, Michiyo Higashi, Shinichi Hashimoto, Shiroh Tanoue, Takao Ohtsuka, Akio Ido, Akihide Tanimoto . Sequential evaluation of <scp>MUC</scp> promoter methylation using next‐generation sequencing‐based custom‐made panels in liquid‐based cytology specimens of pancreatic cancer . Diagnostic Cytopathology50 ( 11 ) 499 - 507 2022.8Reviewed International journal

Language：English Publishing type：Research paper (scientific journal) Publisher：Wiley

BACKGROUND: As liquid-based cytology (LBC) specimens preserve high-quality DNA, clinical sequencing of LBC specimens using next-generation sequencing (NGS) is becoming a common strategy. This study aimed to evaluate the feasibility of NGS-based custom-made panels for evaluating MUC promoter methylation in LBC specimens. METHODS: Thirty-one patients with pancreatic cancer were enrolled in the study. Cancer tissue samples were obtained using endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB). LBC, formalin-fixed paraffin-embedded (FFPE), and fresh frozen specimens were prepared for DNA extraction after pathological diagnosis. These specimens were then subjected to NGS analysis using custom-made cancer gene screening and methylation panels comprising 28 cancer-related genes and 13 gene promoter regions, including MUC1, MUC2, and MUC4. RESULTS: The success rate of NGS using the cancer gene panel was comparable among the LBC, FFPE, and frozen specimens, and the presence of cancer cell-derived somatic mutations in each specimen was confirmed. The specimens were then tested using a methylation panel that revealed the sequential methylation status of CpG islands located in the promoter regions of MUC genes. The methylation status results obtained from LBC specimens were almost comparable with those from FFPE and frozen specimens. CONCLUSIONS: MUC and other gene methylation analyses using an NGS-based panel were successfully performed in residual LBC specimens obtained by EUS-FNA/FNB. Therefore, this approach provides an alternative source of molecular tests for gene mutations and methylation, especially in the pancreatic cancers, which are often unresectable and unsuitable for obtaining FFPE specimens.

DOI： 10.1002/dc.25022

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/dc.25022

窪田恵美, 宿里亜李沙, 岩切かおり, 切田ゆかり, 霧島茉莉, 田崎貴嗣, 北薗育美, 田畑和宏, 東美智代, 谷本昭英 . 乳腺転移を来した膵solid-pseudopapillary neoplasmの1例 . 日本臨床細胞学会九州連合会雑誌53 79 - 82 2022.7Reviewed

Language：Japanese Publisher：日本臨床細胞学会-九州連合会

背景膵solid-pseudopapillary neoplasm(以下、SPN)は、膵外分泌腫瘍の1～3%を占める稀な腫瘍である。今回、乳腺細胞診において原発性乳癌との鑑別に苦慮した膵SPNの乳腺転移の1例を経験したので報告する。症例 50代女性。7年前に手術された膵SPN術後の定期検診にて左乳腺外側に1cm大の結節を指摘された。原発性乳癌が疑われ、針生検及び穿刺針洗浄細胞診が施行された。穿刺針洗浄細胞診で、血性背景に乳頭状、管状あるいは孤立散在性の異型細胞を多数認め、血管性間質を軸とした重積性を示す集塊も存在していた。核偏在傾向や核溝も見られ、浸潤性乳管癌充実型や粘液癌Type Bを疑った。摘出生検では、シート状構造を示す腫瘍細胞と淡好塩基性を示す疎な線維性間質を認め、偽乳頭状構造も認めた。免疫染色では、β-cateninが腫瘍細胞の核・細胞質に陽性であった。以上の所見から膵SPNの乳腺転移と判断した。結論原発性乳癌との鑑別に苦慮した膵SPNの乳腺転移の一例を経験した。膵SPNの肝や腹腔以外への転移は稀ではあるが、臨床情報に留意し検鏡することで診断し得ると考えられた。(著者抄録)

Iwaizako Hiroki, Nishikawa Takuro, Kitazono Ikumi, Tanimoto Akihide, Okamoto Yasuhiro . 急性白血病によく似た所見を呈する原発不明悪性小円形細胞腫瘍(Unknown primary malignant small round cell tumor masquerading as acute leukemia) . Pediatrics International64 ( 1 ) 1 of 3 - 3 of 3 2022.6Reviewed

Language：English Publisher：John Wiley & Sons Australia, Ltd

症例は16歳女性で、4ヵ月前から断続的な左腰背部痛および下肢痛を呈し総合病院を受診した。急性リンパ性白血病と診断され、直ちにプレドニゾロン投与が開始されたが、治療反応は不良であった。その後、小児固形腫瘍の骨髄浸潤が疑われたため当科に転科となった。病理診断の結果、悪性小円形細胞腫瘍であり、小細胞神経内分泌癌の可能性が高かった。PET-CTにて複数の骨、骨髄、腹腔内に異常集積を認めたが、原発巣は特定できなかった。シスプラチン・エトポシド療法後、骨髄検査にて異常細胞の消失が認められ、NSE値の低下も認められた。しかし、2回目の化学療法後、左腸骨病変が拡大し、骨髄に異常細胞が再び出現し、NSEは再び上昇した。がんゲノムプロファイリング検査を実施したが、有効な治療候補は見つからなかった。その後、ビンクリスチン/イリノテカン、左腸骨病変放射線療法、イホスファミド/エトポシド、アムルビシン、エベロリムスなどの治療が行われた。しかし、病状進行に伴い、肝不全、腎不全が再発し、144日目に死亡した。

野元翔平, 上笹貫太郎, 田畑和宏, 谷本昭英, 坂本泰二 . 上眼瞼Merkel細胞癌の1例 . 臨床眼科76 ( 5 ) 597 - 602 2022.5Reviewed

Language：Japanese Publisher：(株)医学書院

＜文献概要＞目的:上眼瞼Merkel細胞癌の症例について報告する。症例:83歳,男性。所見:左上眼瞼の腫瘤を主訴に来院した。細隙灯顕微鏡検査では,左上眼瞼に8×9mm大の赤色調の球状腫瘤を認めた。急速に増大したためMerkel細胞癌を疑い,初診から6日後に左上眼瞼悪性腫瘍拡大切除術を施行した。腫瘍辺縁から5mmのsafety marginをとって拡大切除を行い,術中迅速病理診断で断端の腫瘍細胞が陰性であることを確認した。その後,switch flap法を用いて欠損した眼瞼を再建した。免疫組織学的検査の結果はMerkel細胞癌であった。術翌日に抗凝固薬を再開したところ,創部より多量の出血を認めたため,術後5日目および6日目に止血術を行った。2ヵ月後に同部位に再び腫瘤を認めたが,切除したところ化膿性肉芽腫の診断で再発ではなかった。結論:上眼瞼のMerkel細胞癌を経験した。術後に再度腫瘤を認めたが,再発ではなかった。ただし,再発しやすい腫瘍であるため,今後も慎重な経過観察が必要である。

Fukuda Kosuke, Arigami Takaaki, Tokuda Koki, Yanagita Shigehiro, Matsushita Daisuke, Kawasaki Yota, Iino Satoshi, Sasaki Ken, Nakajo Akihiro, Kirishima Mari, Tanimoto Akihide, Tsubouchi Hitoshi, Kurahara Hiroshi, Ohtsuka Takao . 肝転移を伴うステージIV胃癌に対するラムシルマブ+パクリタキセルのセカンドライン化学療法後のコンバージョン手術　1症例報告(Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report) . Surgical Case Reports8 1 of 7 - 7 of 7 2022.4Reviewed

Language：English Publisher：Springer Berlin Heidelberg

症例は77歳男性で、体重減少をきたして受診した。血清CEA 371.5ng/mLを示し、食道胃十二指腸鏡検査で胃上部から中部1/3にかけて半周性の2型腫瘍を認め、生検後の病理診断では高分化型腺癌であった。造影CTにて腫瘍部における胃壁肥厚、小彎に沿ったリンパ節腫大、肝S3転移を認め、ステージIV HER2陽性胃癌の診断のもと、カペシタビン、シスプラチン、トラスツズマブ投与を予定した。しかし、トラスツズマブの初回投与後に重度の注入部反応を示したため、S-1+シスプラチン(SP療法)に切り替えた。3コース施行後にリンパ節と肝転移巣のサイズ縮小が得られたが、6コース終了後に血清CEAの上昇をきたして腫瘍コントロール不良と判断し、セカンドライン化学療法としてラムシルマブ+パクリタキセルを開始した。6コース終了後、原発巣と肝転移巣の著明な縮小がみられPRと判定、コンバージョン手術を行う方針とした。胃全摘術、D2リンパ節郭清、S3およびS4に対する肝部分切除を施行し、病理所見では原発腫瘍は固有筋層に浸潤しており組織学的グレード1aと考えられた。合併症の発症なく術後10日目に退院となり、42ヵ月後も再発徴候は認めていない。

児島一成, 佐々木文郷, 樺山雅之, 藤野悠介, 軸屋賢一, 田中啓仁, 霧島茉莉, 東美智代, 谷本昭英, 井戸章雄 . 腸管重複症と腔内憩室の鑑別が困難だった腺腫を伴う十二指腸隆起病変の1例 . Gastroenterological Endoscopy64 ( 4 ) 1011 - 1017 2022.4Reviewed

Language：Japanese Publisher：(一社)日本消化器内視鏡学会

症例は63歳の男性.十二指腸下行部に15mm大の側面に陥凹を伴う粘膜下腫瘍様病変で,陥凹面に大小不同の絨毛様構造を認め,管状腺腫もしくは高分化型腺癌が疑われた.超音波内視鏡検査では,腫瘍内部に無エコー域を認めた.早期十二指腸癌も否定できず,EMRを施行した.病理組織検査では,側面の陥凹面は管状腺腫と診断した.また,十二指腸内腔側と嚢胞内腔側は粘膜筋板を共有しており,腺腫を合併した十二指腸重複症が疑われたが,十二指腸腔内憩室(Intraluminal duodenal diverticulum:IDD)との鑑別が困難であった.両疾患は,稀ではあるものの十二指腸腫瘍性病変の鑑別の一つとして考慮すべき疾患と考えられた.(著者抄録)

KOJIMA Issei, SASAKI Fumisato, KABAYAMA Masayuki, FUJINO Yusuke, JIKUYA Kenichi, TANAKA Akihito, KIRISHIMA Mari, HIGASHI Michiyo, TANIMOTO Akihide, IDO Akio . A CASE OF A DUODENAL ELEVATED LESION WITH ADENOMA THAT WERE DIFFICULT TO DISTINGUISH BETWEEN INTESTINAL DUPLICATION AND INTRALUMINAL DIVERTICULUM . GASTROENTEROLOGICAL ENDOSCOPY64 ( 4 ) 1011 - 1017 2022Reviewed

Language：Japanese Publisher：Japan Gastroenterological Endoscopy Society

<p>A 63-year-old man showed a duodenal elevated lesion on esophagogastroduodenoscopy, which was suspected to be an adenocarcinoma or adenoma on the basis of endoscopic findings. He was subsequently referred to our hospital for further examination and treatment. Endoscopic ultrasonography showed a hypoechoic area inside the tumor. The tumor was located on the second part of the duodenum and had a depression on its lateral side. On the basis of these findings, the patient underwent endoscopic mucosal resection. Histological examination of the resected specimen revealed that the depressed area was a tubular adenoma, and the luminal side of the duodenum and cystic area shared muscularis mucosae. The lesion was eventually diagnosed as duodenal duplication or intraluminal duodenal diverticulum with tubular adenoma. Although extremely rare, these diseases should be considered in the differential diagnosis of duodenal elevated lesions.</p>

DOI： 10.11280/gee.64.1011

CiNii Research

古江惠理, 上笹貫太郎, 平木翼, 小牧祐雅, 東裕子, 谷本昭英, 井戸章雄, 坂本泰二 . 眼窩内に寄生したマンソン孤虫症の1例 . 臨床眼科75 ( 8 ) 1031 - 1036 2021.8Reviewed

Language：Japanese Publisher：(株)医学書院

＜文献概要＞緒言:マンソン孤虫症は,マンソン裂頭条虫の幼虫であるプレロセルコイドがヒトに寄生する比較的稀な疾患である。皮下への感染報告がほとんどであり,眼窩内への寄生は,わが国での報告はわずかである。今回,眼窩内のマンソン孤虫症を経験したので報告する。症例:33歳,男性。2017年7月に右眼瞼腫脹が出現し,近医で右眼の結膜炎の診断を受けた。点眼加療で改善しなかったため精査目的で2018年10月に鹿児島大学病院眼科を初診した。右上眼瞼に移動性の腫脹を認め,さらに2年後の造影MRIでは右上直筋付近に占拠性病変が出現した。特発性眼窩炎症の疑いでステロイド内服加療を開始したが,その後の皮膚生検の結果からIgG4関連疾患の診断となった。ステロイド内服を継続したが,改善・増悪を繰り返し寛解には至らなかった。2020年6月に右眼結膜に白色病変を認めたため,摘出術を施行した。摘出後,右眼瞼腫脹は改善した。摘出された白色病変は,病理組織学的検査および寄生虫抗体検査でマンソン孤虫症であると考えられた。結論:眼窩内の寄生虫感染症は稀であり,特発性眼窩炎症やIgG4関連疾患と症状が類似しているため誤診されやすい。ステロイド抵抗性の繰り返す眼瞼腫脹や外眼筋炎の診断には寄生虫感染症も念頭に置くべきである。

Yoshii Daiki, Nakagawa Takenobu, Komohara Yoshihiro, Kawaguchi Hiroaki, Yamada Sohsuke, Tanimoto Akihide . 非アルコール性脂肪性肝疾患マイクロミニブタモデルにおけるマクロファージ活性化の表現型の変化(Phenotypic Changes in Macrophage Activation in a Model of Nonalcoholic Fatty Liver Disease using Microminipigs) . Journal of Atherosclerosis and Thrombosis28 ( 8 ) 844 - 851 2021.8Reviewed

Language：English Publisher：(一社)日本動脈硬化学会

非アルコール性脂肪性肝疾患(NAFLD)マイクロミニブタモデルを用いて、NAFLDの病態進展に伴うマクロファージ表現型の変化について検討した。マイクロミニブタ25頭を普通食群、コレステロール添加高脂肪食(HcD)(0.2%、0.5%、1.5%コレステロール)群、HcD(1.5%コレステロール)+コール酸群の5群に各5頭ずつ分けて、1日1回8週間給餌した。肝臓標本を用いた免疫組織化学染色(マクロファージ、リンパ球、星細胞)を実施した。その結果、Iba-1陽性マクロファージ数は、食餌中コレステロール含量の増加に伴い増加していた。また、CD163陽性マクロファージ数およびCD204陽性マクロファージ数も食餌中コレステロール含量の増加に伴い増加したが、Iba-1陽性マクロファージ中のCD204陽性マクロファージの割合は、コール酸の補給により有意に減少していた。以上から、ブタの肝臓では脂質蓄積によりマクロファージ動員が誘導され、NAFLD初期にはM2様マクロファージが増加し、NAFLD後期にはM1様マクロファージが増加し、非アルコール性脂肪肝炎様状態の肝臓になることが示唆された。

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