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Article: Critical Roles of the Sphingolipid Metabolic Pathway in Liver Regeneration, Hepatocellular Carcinoma Progression and Therapy.

Nojima, Hiroyuki / Shimizu, Hiroaki / Murakami, Takashi / Shuto, Kiyohiko / Koda, Keiji

2024 Volume 16, Issue 5

Abstract: The sphingolipid metabolic pathway, an important signaling pathway, plays a crucial role in various physiological processes including cell proliferation, survival, apoptosis, and immune regulation. The liver has the unique ability to regenerate using ... ...

Abstract	The sphingolipid metabolic pathway, an important signaling pathway, plays a crucial role in various physiological processes including cell proliferation, survival, apoptosis, and immune regulation. The liver has the unique ability to regenerate using bioactive lipid mediators involving multiple sphingolipids, including ceramide and sphingosine 1-phosphate (S1P). Dysregulation of the balance between sphingomyelin, ceramide, and S1P has been implicated in the regulation of liver regeneration and diseases, including liver fibrosis and hepatocellular carcinoma (HCC). Understanding and modulating this balance may have therapeutic implications for tumor proliferation, progression, and metastasis in HCC. For cancer therapy, several inhibitors and activators of sphingolipid signaling, including ABC294640, SKI-II, and FTY720, have been discussed. Here, we elucidate the critical roles of the sphingolipid pathway in the regulation of liver regeneration, fibrosis, and HCC. Regulation of sphingolipids and their corresponding enzymes may considerably influence new insights into therapies for various liver disorders and diseases.
Language	English
Publishing date	2024-02-20
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16050850
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Article: Percutaneous transluminal angioplasty for vertebral artery origin stenosis under the flow-reversal protection using Mo.MA

Ohgaki, Fukutaro / Tomura, Nagatsuki / Shuto, Takashi

Surgical neurology international

2023 Volume 14, Page(s) 406

Abstract: Background: Vertebral artery origin stenosis (VAOS) is a major cause of ischemic stroke of the posterior circulation. Aggressive medical treatment using dual antiplatelet therapy is the most common treatment approach to symptomatic VAOS; however, the ... ...

Abstract	Background: Vertebral artery origin stenosis (VAOS) is a major cause of ischemic stroke of the posterior circulation. Aggressive medical treatment using dual antiplatelet therapy is the most common treatment approach to symptomatic VAOS; however, the effectiveness of endovascular treatment (EVT) for VAOS has recently been reported. Here, we report a case of VAOS treated with percutaneous transluminal angioplasty (PTA) under flow reversal protection using Mo.MA Case description: The patient was a 78-year-old man. He underwent mechanical thrombectomy for acute right posterior cerebral artery occlusion, and recanalization was achieved. Subsequently, artery-to-artery (A-to-A) embolism caused by the right VAOS was revealed as the etiology. PTA under the flow-reversal protection using Mo.MA Conclusion: In EVT for symptomatic VAOS, lesion cross for distal protection device placement is considered to create a high risk of distal embolism due to the anatomic and clinicopathological characteristics of VAOS lesions, especially in A-to-A embolism cases. The flow-reversal protection using Mo.MA
Language	English
Publishing date	2023-11-24
Publishing country	United States
Document type	Case Reports
ISSN	2229-5097
ISSN	2229-5097
DOI	10.25259/SNI_746_2023
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Article ; Online: Leiomyosarcoma Presenting as Rupture With a Type II Endoleak After Thoracic Endovascular Aortic Repair.

Kojima, Takenori / Shuto, Takashi / Hongo, Norio / Miyamoto, Shinji

Vascular and endovascular surgery

2023 Volume 57, Issue 8, Page(s) 937–940

Abstract: Endovascular stent-graft therapy is a commonly performed procedure for aortic lesions worldwide and complications unique to stent grafts, such as postoperative endoleaks, are well known. However, as this treatment modality becomes more popular, ... ...

Abstract	Endovascular stent-graft therapy is a commonly performed procedure for aortic lesions worldwide and complications unique to stent grafts, such as postoperative endoleaks, are well known. However, as this treatment modality becomes more popular, physicians should carefully monitor for other unexpected complications, which may not always be related to the graft. This study presents a case of leiomyosarcoma of the aorta that developed during follow-up for a type II endoleak (T2EL) after thoracic endovascular aortic repair. The presence of the T2EL hindered the diagnosis of the sarcoma at an early stage. These findings suggest that an apparent aneurysm that grows suddenly during follow-up after stent grafting should raise the index of suspicion for a neoplasm as well as an endoleak.
MeSH term(s)	Humans ; Aortic Aneurysm, Abdominal/surgery ; Aortic Aneurysm, Thoracic/surgery ; Endoleak/diagnostic imaging ; Endoleak/etiology ; Endoleak/surgery ; Endovascular Aneurysm Repair/adverse effects ; Leiomyosarcoma/diagnostic imaging ; Leiomyosarcoma/surgery ; Leiomyosarcoma/complications ; Postoperative Complications ; Retrospective Studies ; Stents/adverse effects ; Treatment Outcome
Language	English
Publishing date	2023-06-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2076272-0
ISSN	1938-9116 ; 1538-5744
ISSN (online)	1938-9116
ISSN	1538-5744
DOI	10.1177/15385744231174058
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Article: Stereotactic intensity-modulated radiotherapy for skull base meningioma using the HybridArc with Novalis STx system.

Shuto, Takashi / Matsunaga, Shigeo / Sasame, Jo

Surgical neurology international

2023 Volume 14, Page(s) 420

Abstract: Background: Skull base meningiomas are often difficult to remove completely with preserved nerve function and may require radiation therapy. However, the Gamma Knife is unsuitable for large tumor volume or the optic nerve, which is difficult to identify ...

Abstract	Background: Skull base meningiomas are often difficult to remove completely with preserved nerve function and may require radiation therapy. However, the Gamma Knife is unsuitable for large tumor volume or the optic nerve, which is difficult to identify on imaging. We report the results of stereotactic radiotherapy with HybridArc using Novalis STx for skull base meningiomas. Methods: We retrospectively examined 28 patients with skull base meningioma who underwent stereotactic radiotherapy (54 Gy/30 fractions) with HybridArc. Results: The 28 patients, nine males and 19 females, were aged 31-83 years (mean 58.4 years), and the tumor volume was 2.6-97.1 mL (mean 29.7 mL). HybridArc irradiation was performed with D95 54 Gy/30 fractions for all patients with a median follow-up period of 36.0 months (range: 12-78 months). Tumor control rates at 1, 2, and 5 years after radiotherapy were 92.6%, 89.1%, and 82.8%, respectively. Only one non-atypical meningioma remained uncontrolled; thus, the tumor control rate for non-atypical meningioma at 1, 2, and 5 years was 94.1%. Tumor control rates for atypical meningioma at 1, 2, and 5 years were 85.7%, 71.4%, and 53.6%, respectively, significantly worse than for non-atypical meningiomas ( Conclusion: Stereotactic radiotherapy (54 Gy/30 fractions) with HybridArc using Novalis STx is a safe and effective approach for relatively large skull base meningiomas.
Language	English
Publishing date	2023-12-08
Publishing country	United States
Document type	Journal Article
ISSN	2229-5097
ISSN	2229-5097
DOI	10.25259/SNI_815_2023
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Article ; Online: Thyroid metastasis from cervical carcinoma.

Hayashi, Shuto / Kumai, Takumi / Michizuka, Tomohiko / Osaki, Takashi

Brazilian journal of otorhinolaryngology

2023 Volume 89, Issue 4, Page(s) 101268

MeSH term(s)	Humans ; Thyroid Neoplasms/pathology ; Carcinoma/pathology ; Lymph Nodes/pathology
Language	English
Publishing date	2023-03-22
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2428110-4
ISSN	1808-8686 ; 1808-8694
ISSN (online)	1808-8686
ISSN	1808-8694
DOI	10.1016/j.bjorl.2023.03.005
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Article: Outcomes of Gamma Knife Radiosurgery for Brain Metastases From Anaplastic Lymphoma Kinase Rearrangement-Positive and EGFR Mutation-Positive Non-Small Cell Lung Cancer.

Matsunaga, Shigeo / Shuto, Takashi

Cureus

2021 Volume 13, Issue 12, Page(s) e20398

Abstract: Introduction The outcomes after gamma knife radiosurgery (GKRS) were retrospectively analysed in patients with brain metastases from anaplastic lymphoma kinase (ALK) rearrangement-positive and epidermal growth factor receptor (EGFR) mutation-positive non- ...

Abstract	Introduction The outcomes after gamma knife radiosurgery (GKRS) were retrospectively analysed in patients with brain metastases from anaplastic lymphoma kinase (ALK) rearrangement-positive and epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC) to evaluate the efficacy, safety and difference for overall survival and local tumor control. Methods The medical records were retrospectively reviewed of 607 patients (25 ALK-positive, 171 EGFR-positive, and 411 wild type) with 2959 tumors who had undergone GKRS. Results The median overall survival time after initial GKRS was 14 months. Driver gene mutation-positive patients had significantly longer overall survival than wild type patients (p < 0.0001), and ALK-positive patients survived significantly longer than EGFR-positive patients (p = 0.04). Multivariate analysis showed the unfavorable factors significantly affecting overall survival outcomes were older age, lower Karnofsky Performance Status score, multiple intracranial metastases, uncontrolled primary cancer, uncontrolled extracranial metastases, no administration of immune checkpoint inhibitors, and driver gene mutation-negative cases. Seventy-three patients died of uncontrolled brain metastases at a median of 12 months. Driver gene mutations had no influence (p = 0.33), and ALK-positive and EGFR-positive patients showed no significant difference in neurological survival (p = 0.83). A total of 174 patients demonstrated distant brain control failure at a median of 15 months. ALK-positive type was significant compared with EGFR-positive type (p = 0.047), but driver gene mutation-positive and -negative types showed no significant difference in the development of new brain metastases (p = 0.2). The median tumor volume was 1.06 cm
Language	English
Publishing date	2021-12-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.20398
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Article: Volume-Staged Radiosurgery for Large Arteriovenous Malformation: Retrospective Analysis of 19 Cases.

Shuto, Takashi / Matsunaga, Shigeo

Cureus

2021 Volume 13, Issue 8, Page(s) e16901

Abstract: Introduction The effectiveness of Gamma Knife surgery (GKS) for small arteriovenous malformations (AVMs) is well known. However, for large AVMs, the prescribed dose should be decreased to reduce the risk of radiation damage, but it leads to a decrease in ...

Abstract	Introduction The effectiveness of Gamma Knife surgery (GKS) for small arteriovenous malformations (AVMs) is well known. However, for large AVMs, the prescribed dose should be decreased to reduce the risk of radiation damage, but it leads to a decrease in nidus obliteration rates. Therefore, it is very difficult to achieve complete obliteration of large AVMs in a single treatment, and methods using multiple irradiation such as volume-staged stereotactic radiosurgery (VS-SRS) have been suggested. We retrospectively reviewed our results of VS-SRS for large AVMs to assess the efficacy of VS-SRS. Methods Nineteen patients with AVMs of ≥10 ml and who consented to VS-SRS were treated by this surgical strategy and retrospectively analyzed. We excluded AVMs that were too large such as those >40 cc to avoid severe radiation damage. The components were divided mainly in the vertical direction, and each component was irradiated with a marginal dose of 18 Gy. Each irradiation was performed at intervals of 3-6 months, and the components with main feeders were irradiated first, and the components that included the main drainer were irradiated last. We tried to keep V18 to <10 ml if possible. The follow-up after GKS was performed by MRI every 6 months, and cerebral angiography was performed to confirm complete nidus obliteration, but if the patient refused, it was judged on the basis of MRI findings. Results Nineteen patients with a mean age of 40.2 years underwent VS-SRS. Each compartment was irradiated at 3--16 month (median, 3 months) intervals. The mean initial AVM volume was 19 ± 5.6 ml. Fourteen patients received two-stage radiosurgery and five received three-stage radiosurgery. The median target volume was 9.1 ml at stage 1, 9.0 ml at stage 2, and 10.1 ml at stage 3. The median margin dose was 18 Gy at each stage. The mean follow-up after the last stage of radiosurgery was 3.9 (1-11.4) years. Complete obliteration was confirmed by angiography in six patients, and by magnetic resonance angiography in one patient. The cumulative obliteration rates were 30.7% and 58.2% at 3 and 5 years following VS-SRS, respectively. The cumulative hemorrhage rates were 7.1% and 22.1% at 3 and 5 years, respectively. MRI showed T2-weighted prolongation in 15 patients (78.9%). Of these 15 patients, four were symptomatic (epilepsy in all) and two underwent surgical removal of symptomatic expanding hematomas. Conclusions In our experience, VS-SRS offers a viable treatment strategy in patients with large AVMs. Further optimization of the dose and volume at each stage is required.
Language	English
Publishing date	2021-08-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.16901
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Article ; Online: Authors' reply to "Pathogenesis of radiosurgery-induced cyst formation in patients with arteriovenous malformation".

Shuto, Takashi

Acta neurochirurgica

2015 Volume 157, Issue 5, Page(s) 779–780

Language	English
Publishing date	2015-05
Publishing country	Austria
Document type	Comment ; Letter
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-015-2398-4
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Article: [Results of Watch and Wait after Chemoradiotherapy for Locally Advanced Rectal Cancer].

Usui, Akihiro / Kosugi, Chihiro / Shuto, Kiyohiko / Nojima, Hiroyuki / Murakami, Takashi / Yamazaki, Masashi / Shimizu, Hiroaki / Koda, Keiji

Gan to kagaku ryoho. Cancer & chemotherapy

2024 Volume 51, Issue 2, Page(s) 193–195

Abstract: Background: Watch and wait(W & W)for rectal cancer after chemoradiotherapy(CRT)is attracting attention.: Purpose: To examine regimens and indications from the results of follow-up of cases undergoing W & W in our department.: Materials and methods!# ...

Abstract	Background: Watch and wait(W & W)for rectal cancer after chemoradiotherapy(CRT)is attracting attention. Purpose: To examine regimens and indications from the results of follow-up of cases undergoing W & W in our department. Materials and methods: CRT(SOX therapy 2-5 cycles, 45 Gy)was performed on patients with lower rectal cancer over a period of 2016 to 2020, and 7 patients with clinical complete response(cCR)were followed up. Results: With a median follow-up of 33 months(10-74), 4 of 7 patients(57.1%)remained in cCR. Two patients had local relapse more than a year after the start of treatment, were able to undergo salvage surgery, and are alive after surgery. Patients with lateral lymph node metastasis before CRT had para-aortic lymph node metastasis at 8 months. Conclusions: Patients with maintained cCR were those with localized, node-negative disease. On the other hand, in patients with lymph node metastasis, including lateral metastasis, it was not possible to perform salvage surgery due to distant metastasis. Careful case selection and follow-up are necessary in the future.
MeSH term(s)	Humans ; Lymphatic Metastasis ; Rectal Neoplasms/therapy ; Chemoradiotherapy ; Lymph Nodes ; Neoplasms, Second Primary
Language	Japanese
Publishing date	2024-03-07
Publishing country	Japan
Document type	English Abstract ; Journal Article
ZDB-ID	604842-0
ISSN	0385-0684
ISSN	0385-0684
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Article: Carotid Artery Bypass Surgery of In-Body Tissue Architecture-Induced Small-Diameter Biotube in a Goat Model: A Pilot Study.

Umeno, Tadashi / Mori, Kazuki / Iwai, Ryosuke / Kawashima, Takayuki / Shuto, Takashi / Nakashima, Yumiko / Tajikawa, Tsutomu / Nakayama, Yasuhide / Miyamoto, Shinji

Bioengineering (Basel, Switzerland)

2024 Volume 11, Issue 3

Abstract: Biotubes are autologous tubular tissues developed within a patient's body through in-body tissue architecture, and they demonstrate high potential for early clinical application as a vascular replacement. In this pilot study, we used large animals to ... ...

Abstract	Biotubes are autologous tubular tissues developed within a patient's body through in-body tissue architecture, and they demonstrate high potential for early clinical application as a vascular replacement. In this pilot study, we used large animals to perform implantation experiments in preparation for preclinical testing of Biotube. The biological response after Biotube implantation was histologically evaluated. The designed Biotubes (length: 50 cm, internal diameter: 4 mm, and wall thickness: 0.85 mm) were obtained by embedding molds on the backs of six goats for a predetermined period (1-5 months). The same goats underwent bypass surgery on the carotid arteries using Biotubes (average length: 12 cm). After implantation, echocardiography was used to periodically monitor patency and blood flow velocity. The maximum observation period was 6 months, and tissue analysis was conducted after graft removal, including the anastomosis. All molds generated Biotubes that exceeded the tensile strength of normal goat carotid arteries, and eight randomly selected Biotubes were implanted. Thrombotic occlusion occurred immediately postoperatively (1 tube) if anticoagulation was insufficient, and two tubes, with insufficient Biotube strength (<5 N), were ruptured within a week. Five tubes maintained patency for >2 months without aneurysm formation. The spots far from the anastomosis became stenosed within 3 months (3 tubes) when Biotubes had a wide intensity distribution, but the shape of the remaining two tubes remained unchanged for 6 months. The entire length of the bypass region was walled with an αSMA-positive cell layer, and an endothelial cell layer covered most of the lumen at 2 months. Complete endothelial laying of the luminal surface was obtained at 3 months after implantation, and a vascular wall structure similar to that of native blood vessels was formed, which was maintained even at 6 months. The stenosis was indicated to be caused by fibrin adhesion on the luminal surface, migration of repair macrophages, and granulation formation due to the overproliferation of αSMA-positive fibroblasts. We revealed the importance of Biotubes that are homogeneous, demonstrate a tensile strength > 5 N, and are implanted under appropriate antithrombotic conditions to achieve long-term patency of Biotube. Further, we clarified the Biotube regeneration process and the mechanism of stenosis. Finally, we obtained the necessary conditions for a confirmatory implant study planned shortly.
Language	English
Publishing date	2024-02-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2746191-9
ISSN	2306-5354
ISSN	2306-5354
DOI	10.3390/bioengineering11030203
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