Ueda, Ryo

写真a

Affiliation

School of Medicine, Department of Neurosurgery (Shinanomachi)

Position

Assistant Professor/Senior Assistant Professor

External Links

 

Papers 【 Display / hide

  • Endoscopic Endonasal Reconstruction Using a Pedicled Middle Turbinate Flap for Spontaneous Cerebrospinal Fluid Rhinorrhea.

    Takahara K, Ueda R, Toda M

    The Journal of craniofacial surgery (Journal of Craniofacial Surgery)  33 ( 3 ) e318 - e320 2022.05

    ISSN  1049-2275

     View Summary

    AbstractAlthough endoscopic skull-base reconstruction protocols to reduce cerebrospinal fluid (CSF) leakage are reported, the most effective management strategies have not been determined. We describe the successful repair of a spontaneous CSF leak using a vascularized middle turbinate flap (MTF) via an endonasal endoscopic approach and also discuss the effective reconstruction with other available pedicled flaps. An 11-year-old girl had a 5-month history of intermittent CSF rhinorrhea. Endoscopic endonasal skull base reconstruction was performed using the pedicled MTF technique, which sufficiently covered the unilateral cribriform plate and ethmoidal fovea including suspicious leakage site. Middle turbinate flaps may be good for repairing spontaneous CSF leaks, which commonly have small, low-flow CSF fistulas around a cribriform plate. As spontaneous CSF leaks are known to have a higher recurrence rate, MTF may be advantageous because more of the normal structures are retained.

  • Long-Term Outcomes of Endoscopic Cyst Fenestration for Rathke Cleft Cyst.

    Yamada H, Ueda R, Ozawa H, Toda M

    World neurosurgery (World Neurosurgery)   2022.02

    ISSN  1878-8750

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    Objective: We sought to elucidate the long-term surgical outcomes and incidence of recurrence and reoperation of endoscopic endonasal cyst fenestration for Rathke cleft cyst (RCC). Methods: A retrospective review of the chart and operation record of RCC surgical cases between January 2008 and August 2021 at our institution was conducted. Patient characteristics, intraoperative findings, and postoperative follow-up outcomes were evaluated. Results: A total of 27 patients were analyzed, with a median postoperative follow-up period of 52 months (range, 1–150 months). Preoperative symptoms were visual dysfunction (59%), headache (41%), and pituitary dysfunction (22%). Endoscopic cyst fenestration was performed in all patients. Ten (37%) patients had intraoperative cerebrospinal fluid leakage. Among them, the only patient in whom sellar floor reconstruction was not performed experienced a repair operation due to postoperative cerebrospinal fluid leakage. No patients experienced postoperative hypopituitarism. Preoperative headache, visual dysfunction, and pituitary hormone disorder improved in 73%, 75%, and 67% of patients, respectively. Although postoperative cyst regrowth was observed in 8 patients (30%), no patient experienced worsening or novel symptoms and none required reoperation. Conclusions: Patients with a symptomatic RCC can be effectively treated with endoscopic endonasal cyst fenestration. Reversal of the presenting symptoms resulted, including headache, visual dysfunction, and pituitary hormone dysfunction, in the majority of patients. In our series, appropriate reconstruction of the sellar floor reduced the risk of postoperative cerebrospinal fluid leakage without impacting cyst regrowth. This simple technique appears to effectively disrupt cyst progression in most cases, even after a relatively long-term follow-up period.

  • 巨大下垂体腫瘍に対する経頭蓋・経鼻同時手術の意義と適応の再考

    植田 良, 小澤 宏之, 戸田 正博

    Folia Endocrinologica Japonica (The Japan Endocrine Society)  97 ( 0 ) 75 - 77 2021

    ISSN  0029-0661

  • [Endoscopic Endonasal Skull Base Surgery Using the 'Four Hands-Two Nostrils' Technique by a Surgical Team Composed of an ENT Surgeon and a Neurosurgeon].

    Toda M, Ueda R, Ozawa H

    No shinkei geka. Neurological surgery 48 ( 10 ) 885 - 893 2020.10

    ISSN  0301-2603

  • Clinical and histopathological analyses of VEGF receptors peptide vaccine in patients with primary glioblastoma - A case series

    Tamura R., Morimoto Y., Kosugi K., Sato M., Oishi Y., Ueda R., Kikuchi R., Nagashima H., Noji S., Kawakami Y., Sasaki H., Yoshida K., Toda M.

    BMC Cancer (BMC Cancer)  20 ( 1 )  2020.03

     View Summary

    © 2020 The Author(s). Background: The expression of vascular endothelial growth factor (VEGF)-A/ VAGF receptors (VEGFRs) signaling plays a pivotal role in the tumor angiogenesis and the development of the immunosuppressive tumor microenvironment in glioblastomas. We have previously conducted exploratory clinical studies investigating VEGFRs peptide vaccination with and without multiple glioma oncoantigens in patients with recurrent high-grade gliomas. Recently, an exploratory clinical investigation of VEGFRs peptide vaccination was conducted in patients with progressive neurofibromatosis type 2. Those studies suggested that cytotoxic T lymphocytes (CTLs) induced by the vaccination can directly kill a wide variety of cells associated with tumor growth, including tumor vessels, tumor cells, and immunosuppressive cells expressing VEGFR1 and/or 2. In the present study, synergistic activity of the combination of VEGFRs peptide vaccination with chemotherapy was evaluated. Methods: We performed the first clinical trial to assess VEGFR1 and 2 vaccination along with temozolomide (TMZ) -based chemoradiotherapy for the patients with primary glioblastomas. Furthermore, histopathological changes after the vaccination were evaluated using paired pre- and post- vaccination specimens. Results: The disappearance of radiographically enhanced lesion was observed in 2 patients after the vaccination, including one in which the methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter was not observed. The histopathological findings of pre- and post-vaccination specimens demonstrated that tumor vessels showed negative or slight VEGFRs expressions after the vaccination and most endothelial cells were covered with PDGFR-β-positive pericytes. Notably, CTLs induced by VEGFRs peptide vaccination attacked not only tumor vessels but also tumor cells and regulatory T cells expressing VEGFRs even in recurrent tumors. Conclusions: VEGFR1 and 2 vaccination may have a preliminary synergistic effect when administered with TMZ. The limitation of the present study was the paucity of the number of the samples. Further studies involving more patients are warranted to confirm the findings of this study. Trial registration: This study was registered as UMIN000013381 (University Hospital Medical Information Network-Clinical Trial Registry: UMIN-CTR) on 5 March, 2014 and with the Japan Registry of Clinical Trials (jRCT) as jRCTs031180170 on 1 March, 2019.

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Papers, etc., Registered in KOARA 【 Display / hide

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Reviews, Commentaries, etc. 【 Display / hide

  • 【脳神経外科医のための疾患・症状別当直マニュアル】知っておきたい外来対応(疾患・症状編) めまい・ふらつきを訴える患者

    植田 良, 戸田 正博

    脳神経外科速報 ((株)メディカ出版)  32 ( 2 ) 234 - 238 2022.03

    ISSN  0917-1495

  • Pipeline留置後に脳内多発性造影病変を認めた1例

    山田 浩貴, 秋山 武紀, 中屋 雅人, 富岡 あず菜, 植田 良, 戸田 正博

    脳血管内治療 ((NPO)日本脳神経血管内治療学会)  6 ( Suppl. ) S279 - S279 2021.11

    ISSN  2423-9119

  • 脳・頭頸部腫瘍塞栓術における難易度のgradingの試み

    秋山 武紀, 水谷 克洋, 高橋 里史, 植田 良, 戸田 正博

    脳血管内治療 ((NPO)日本脳神経血管内治療学会)  6 ( Suppl. ) S21 - S21 2021.11

    ISSN  2423-9119

  • 経鼻内視鏡下頭蓋底手術における鼻中隔粘膜弁の再挙上

    小澤 宏之, 関水 真理子, 中村 伸太郎, 御子柴 卓弥, 永井 遼斗, 渡部 佳弘, 植田 良, 戸田 正博, 小川 郁

    日本耳鼻咽喉科学会会報 ((一社)日本耳鼻咽喉科学会)  124 ( 4 ) 641 - 641 2021.04

    ISSN  0030-6622

  • 【頭蓋底腫瘍の治療オプション-開頭手術・内視鏡手術・放射線治療】傍鞍部〜蝶形骨縁(髄膜腫)部位による症状と手術適応

    植田 良, 戸田 正博

    Clinical Neuroscience ((株)中外医学社)  39 ( 4 ) 441 - 443 2021.04

    ISSN  0289-0585

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Presentations 【 Display / hide

  • グリオーマ患者血清IgG抗体に認識される精巣組織由来グリオーマ抗原の単離と解析

    植田良,戸田正博,吉田一成,河上裕,河瀬斌

    第61回日本脳神経外科学会総会, 

    2002.10

    Oral presentation (general)

  • SEREX法を用いた精巣組織由来グリオーマ抗原の単離とその解析

    Ueda Ryou, Toda Masahiro, Yoshida Kazunari, Kawase Takeshi, Kawakami Yutaka

    第6回基盤的癌免疫研究総会, 

    2002.07

    Oral presentation (general)

  • Serological identification of SOX D group proteins as highly immunogenic cancer-testis antigen in glioma

    Ueda Ryo, Toda Masahiro, Kawase Takeshi, Kawakami Yutaka

    American Association for Cancer Research. Annual Meeting, 

    2002.07

    Oral presentation (general)

  • 精巣組織由来のグリオーマ抗原遺伝子の単離

    植田良,戸田正博,吉田一成,河上裕,河瀬斌

    第6回Waterfront Neurosurgical Conference, 

    2002.07

    Oral presentation (general)

  • 精巣組織由来の新規グリオーマ抗原の単離

    植田良,戸田正博,吉田一成,河上裕,河瀬斌

    第23回ニューロオンコロジーの会, 

    2002.07

    Oral presentation (general)

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Research Projects of Competitive Funds, etc. 【 Display / hide

  • 難治性脳腫瘍新生血管を標的としたペプチドワクチン療法の臨床効果予測因子の検証

    2021.04
    -
    2024.03

    Keio University, Grant-in-Aid for Scientific Research (C), No Setting

     View Summary

    本研究では、難治性脳腫瘍に対するペプチドワクチン療法臨床試験被験者の様々な検体を用いて個々の患者における正・負の免疫動態を総合的に評価し、①同ペプチドワクチン療法の効果が期待できる症例の選出方法開発(免疫療法の有効性を予測するための免疫バイオマーカー探索)、②免疫バイオマーカーにより同免疫療法と抗がん剤との組み合わせなどの免疫制御法の改良技術を評価する。本研究成果は、本治療に対する治療反応性予測を可能にし、治療成績向上につながる可能性がある。また、脳腫瘍免疫および脳腫瘍血管新生・浸潤性における新たな機構の解明につながり、治療困難な脳腫瘍の治療成績の改善に貢献することが期待される。

  • 悪性脳腫瘍に対するウイルス搭載iPS細胞を用いた新規治療の開発

    2021.04
    -
    2024.03

    Keio University, Grant-in-Aid for Scientific Research (B), No Setting

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    悪性神経膠腫(グリオーマ)は、グリオーマ幹細胞(GSC)の存在により、強い浸潤性お
    よび治療抵抗性を示す。本研究では、治療抵抗性・浸潤性GCSに追従するiPS細胞由来神経
    幹細胞を、自殺遺伝子搭載複製型ウイルスの”producing cell” かつ“delivery vehicle”として用いる革新的な新規治療法を開発する。

  • 悪性脳腫瘍新生血管を治療標的としたペプチドワクチン療法の有効性予測因子の解明

    2018.04
    -
    2021.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

  • Biomarkers for evaluation of clinical activity of VEGFR-targeted vaccines against malignant glioma patients

    2015.04
    -
    2018.03

    Keio University, UEDA RYO, TODA MASAHIRO, Grant-in-Aid for Scientific Research (C), No Setting

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    Evaluation of immunological biomarkers may lead to better understanding of the critical immune response indicators that may help to predict clinical responses of cancer immunotherapy. We characterized status of immune cells, cytokines, chemokines, and other immunosuppressive molecules in malignant glioma patients who received vaccinations of VEGF receptor (VEGFR)-derived peptides. Peripheral blood samples from patients who demonstrated positive radiologic response or stable disease revealed superior VEGFR-specific CTL reactivity and lower level of serum VEGF compared to samples from other patients with progressing malignant glioma. Plasma IL-8 level was negatively correlated with overall survival. These data indicate that these parameters may be potential immune-biomarkers for evaluation of clinical activity of VEGFR-targeted vaccines.

  • Immunotherapy targeting brain tumor stem cell antigen and niche

    2012.04
    -
    2015.03

    Keio University, TODA Masahiro, UEDA Ryo, Grant-in-Aid for Challenging Exploratory Research, No Setting

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    In this study, we demonstrated that glioma cells and brain tumor stem cells (BTSCs) expressed highly VEGF (vascular endothelial growth factor) and VEGFR (vascular endothelial growth factor receptor) in vitro. Furthermore, VEGFR was shown to express highly within malignant glioma tissues compared with surrounding brain tissue. In a clinical study, we performed a novel immunotherapy using VEGFR1/VEGFR2 peptides in 8 patients with recurrent malignant glioma and analyzed the cytotoxic T lymphocytes (CTLs) specific to VEGFR1/VEGFR2. After the vaccination with VEGFR1/VEGFR2, CTLs specific to VEGFR1 were induced in 6 out of 6 patients analyzed and CTLs specific to VEGFR2 in 2 out of 6 patients. These results suggest that an immunotherapy using VEGFR1/2 peptides to inhibit the VEGF/VEGFR signal may be effective for the treatment of malignant glioma.

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Courses Taught 【 Display / hide

  • LECTURE SERIES, NEUROSURGERY

    2022

  • LECTURE SERIES, NEUROSURGERY

    2021