Publications by authors named "Shinji Kawabata"

ObjectiveAn aging or aged society is and has been a reality in many developed countries. Additionally, the incidence of subarachnoid hemorrhage (SAH) in elderly patients has been estimated to be increasing. However, the outcomes of SAH treatment by clipping or coiling in elderly patients are poor.

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Purpose: The Phase II clinical trial (JG002) investigating accelerator-based boron neutron capture therapy (AB-BNCT) using a cyclotron-based epithermal neutron source for recurrent malignant gliomas has since concluded. The trial demonstrated favorable survival outcomes during the 1-year evaluation period defined in the protocol for patients with recurrent glioblastoma, a population with notoriously poor prognosis. Follow-up was originally limited to up to two years.

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Boron neutron capture therapy (BNCT) is one of the promising cancer treatment methods with B-labeled compounds and neutron irradiation. The B(n,α)Li reaction produces a Li nucleus and an α-particle with high linear energy transfer, which are responsible for the therapeutic effects. We hypothesized that BNCT could effectively treat bone metastases by selectively accumulating B at metastatic lesion sites.

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Jugular foramen schwannoma is a rare intracranial tumor, with few opportunities for surgeons to perform tumor excision. This study aimed to provide an outline of jugular foramen schwannoma and our surgical strategy for this tumor. The surgical approach depends on tumor growth patterns with or without extracranial extension.

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Surgery for spinal intramedullary tumors remains a major challenge for neurosurgeons. Successful surgery requires experience, skill, and intraoperative imaging support. Fluorescence imaging technology has become a valuable support in neurosurgical procedures of not only the brain but also the spinal cord.

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Background: Cerebral autoregulation is a robust regulatory mechanism that stabilizes cerebral blood flow in response to reduced blood pressure, thereby preventing cerebral ischaemia. Scientists have long believed that cerebral autoregulation also stabilizes cerebral blood flow against increases in intracranial pressure, which is another component that determines cerebral perfusion pressure. However, this idea was inconsistent with the complex pathogenesis of normal pressure hydrocephalus, which includes components of chronic cerebral ischaemia due to mild increases in intracranial pressure.

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Background: C5 palsy is a frequent complication following cervical spine surgery, particularly after posterior approaches. Although several risk factors have been proposed, the incidence of C5 palsy after anterior cervical discectomy and fusion (ACDF) remains less well understood. This study aims to elucidate the risk factors and neurological recovery associated with C5 palsy following ACDF.

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Background: A previous Phase II clinical trial, conducted from 1995 to 2003, evaluated CNS germ cell tumors (GCTs) using a three-group treatment stratification based on histopathology. The primary objective of the study was to assess the long-term efficacy of standardized treatment regimens, while the secondary objective focused on identifying associated long-term complications.

Methods: A total of 228 patients were classified into 3 groups for treatment: germinoma (n = 161), intermediate prognosis (n = 38), and poor prognosis (n = 28), excluding one mature teratoma case.

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Article Synopsis
  • The debate about how effective radiotherapy is for treating meningiomas is ongoing and lacks strong evidence, but recent WHO classification updates and molecular diagnostics have improved how we assess the risks of recurrence.
  • While there's a growing understanding of when radiotherapy might be necessary, its effectiveness for high-risk meningiomas remains debated.
  • New techniques, like combining PET imaging with MRI and exploring boron neutron capture therapy, are being recognized as beneficial for targeting tumor cells, especially in cases where meningiomas invade surrounding brain tissue.
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Boron neutron capture therapy (BNCT) is a cancer treatment modality based on the nuclear capture and fission reactions that occur when boron-10, a stable isotope, is irradiated with neutrons of the appropriate energy to produce boron-11 in an unstable form, which undergoes instantaneous nuclear fission to produce high-energy, tumoricidal alpha particles. The primary purpose of this review is to provide an update on the first drug used clinically, sodium borocaptate (BSH), by the Japanese neurosurgeon Hiroshi Hatanaka to treat patients with brain tumors and the second drug, boronophenylalanine (BPA), which first was used clinically by the Japanese dermatologist Yutaka Mishima to treat patients with cutaneous melanomas. Subsequently, BPA has become the primary drug used as a boron delivery agent to treat patients with several types of cancers, specifically brain tumors and recurrent tumors of the head and neck region.

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-type Japanese rice wine () has a wide variety of flavors, as the predominant microbes, including lactic acid bacteria (LAB) and nitrate-reducing bacteria, that spontaneously proliferate in the fermentation starter vary depending on the brewery. In this study, we traced the microbiota in four lots of starters manufactured in a newly established brewery and evaluated the lot-to-lot variation and characteristics of the microbiota in the brewery. The results of a 16S ribosomal RNA amplicon analysis showed that the starters brewed in the second brewing year had a more diverse microbiota than those in the first brewing year.

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Article Synopsis
  • Metastatic spinal tumors are becoming more common as cancer treatments improve, emphasizing the necessity for better therapies.
  • Boron neutron capture therapy (BNCT) shows potential by targeting tumors and sparing healthy tissue, making it a promising treatment option.
  • In a study on mice with lung adenocarcinoma, BNCT significantly improved survival rates and preserved neurological function compared to untreated and neutron-only groups, while showing no adverse effects.
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Background: Boron neutron capture therapy (BNCT) is a precise particle radiation therapy known for its unique cellular targeting ability. The development of innovative boron carriers is crucial for the advancement of BNCT technologies. Our previous study demonstrated the potential of PBC-IP administered via convection-enhanced delivery (CED) in an F98 rat glioma model.

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Boron neutron capture therapy (BNCT) is a type of targeted particle radiation therapy with potential applications at the cellular level. Spinal cord gliomas (SCGs) present a substantial challenge owing to their poor prognosis and the lack of effective postoperative treatments. This study evaluated the efficacy of BNCT in a rat SCGs model employing the Basso, Beattie, and Bresnahan (BBB) scale to assess postoperative locomotor activity.

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Airway complications that occur after anterior cervical spine surgery pose a life-threatening risk, which encompasses complications including prolonged intubation, unplanned reintubation, and/or necessity of tracheostomy. The present study aimed to identify the surgical risks associated with postoperative airway complications in neurosurgical training institutes. A retrospective, multicenter, observational review of data from 365 patients, who underwent anterior cervical spine surgery between 2018 and 2022, at three such institutes was carried out.

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Preoperative simulation images creates an accurate visualization of a surgical field. The anatomical relationship of the cranial nerves, arteries, brainstem, and related bony protrusions is important in skull base surgery. However, an operator's intention is unclear for a less experienced neurosurgeon.

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Article Synopsis
  • Preoperative embolization for meningiomas is debated regarding its benefits for reducing surgical blood loss and time, with mixed reports on its effectiveness, especially for larger tumors.
  • A study compared outcomes in patients who underwent craniotomy for meningiomas with and without preoperative embolization, analyzing factors like tumor size and intraoperative bleeding from data collected between January 2015 and April 2022.
  • Results showed that embolization significantly reduced blood loss for larger tumors (≥40 mm), and while complications were low, hypertensive patients without embolization experienced more bleeding during surgery.
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Background: In the cervical nerve sheath tumor (NST) surgery with dumbbell extension of Eden type 2 or 3, selection of anterior, posterior, or combined approach remains controversial.

Objectives: This technical note aimed to propose possible advantages of the posterior unilateral approach (PUA). Methods: Six patients who underwent the surgical treatment of cervical NSTs with dumbbell extension of Eden type 2 or 3 were included.

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We report the case of a 70-year-old woman with metastatic brain tumors who underwent surgical removal of the tumor and radiation necrosis. The patient had a history of colon cancer and had undergone surgical removal of a left occipital tumor. Histopathological evaluation revealed a metastatic brain tumor.

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Malignant glioma is a highly invasive tumor, and elucidating the glioma invasion mechanism is essential for developing novel therapies. We aimed to highlight actin alpha 2, smooth muscle (ACTA2) as potential biomarkers of brain invasion and distant recurrence in malignant gliomas. Using the human malignant glioma cell line, U251MG, we generated ACTA2 knockdown (KD) cells treated with small interfering RNA, and the cell motility and proliferation of the ACTA2 KD group were analyzed.

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Objective: This study aimed to report the outcome of an endovascular treatment with a pipeline embolization device (PED) at a single center. We also examined the predictive factors for an incomplete occlusion after the PED placement.

Methods: The subjects were 94 patients with 109 aneurysms who underwent the PED placement at our single center from June 2015 to September 2022.

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Objective: This study aimed to clarify the differences in the perioperative data of patients with extramedullary and intramedullary tumors and estimate the impact of surgery on medical costs.

Methods: This single-center retrospective study included consecutive patients who underwent spinal tumor resection between September 2020 and December 2022. The perioperative medical information and medical costs for individual patients were obtained from their medical records.

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Article Synopsis
  • - Glioblastoma typically recurs in the brain, with rare cases of extracranial metastases; lymph node involvement is often discovered through symptoms or lymphadenopathy.
  • - The case study presented involves a patient with asymptomatic lymph node metastasis and rising C-reactive protein levels, leading to a diagnosis 9 months later when fever developed without prior signs of infection.
  • - The findings suggest that C-reactive protein levels might be a useful indicator for detecting lymph node metastasis in glioblastoma patients, warranting further investigation.
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High-grade gliomas present a significant challenge in neuro-oncology because of their aggressive nature and resistance to current therapies. Boron neutron capture therapy (BNCT) is a potential treatment method; however, the boron used by the carrier compounds-such as 4-borono-L-phenylalanine (L-BPA)-have limitations. This study evaluated the use of boron-conjugated 4-iodophenylbutanamide (BC-IP), a novel boron compound in BNCT, for the treatment of glioma.

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Background: The authors report a case of occult neurohypophyseal germinoma detected in a patient with long-term diabetes insipidus. Central diabetes insipidus is the initial symptom in 95% of cases of neurohypophyseal germinoma. In occult neurohypophyseal germinomas, no abnormalities are seen on magnetic resonance imaging (MRI) at the onset of symptoms.

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