Publications by authors named "Kashihara T"

Diabetic retinopathy is a major ocular complication associated with diabetes mellitus. Pericyte loss is a hallmark of diabetic retinopathy. The platelet-derived growth factor (PDGF)-B-PDGF receptor-β (PDGFRβ) signaling pathway plays an important role in the proliferation and migration of pericytes.

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Objectives: Recently, various endoscopic treatments for colorectal polyps have been reported, including cold snare polypectomy (CSP) and underwater endoscopic mucosal resection (UEMR), in addition to EMR. However, a precise treatment strategy for sessile serrated lesions (SSL) has not been established. In this study, we analyzed the clinicopathological features of SSL resected by EMR, CSP, and UEMR to determine the most suitable treatment for SSL.

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We have investigated the base-induced long-range halogen dance reactions of 4,5-dibromo- or 4-bromo-5-iodothiazoles bearing sulfur-containing aromatic heterocycles at the C2-position. We have found that the reaction occurs in bithiazole regioisomers or (thiophenyl)thiazole derivatives, in which the C-5 halo group on the thiazole halogen donor regioselectively migrates to a halogen acceptor ring after treatment with lithium bis(trimethylsilyl)amide. The substrate with a thiophen-2-yl substituent required highly basic P4-t-Bu to induce the halogen dance reaction.

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Background: To analyze in a prospective study the long-term safety and efficacy of 3-dimensional conformal radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI) for Japanese women with early breast cancer.

Methods: Breast cancer patients with pathological tumor size ≤ 3 cm, age ≥ 20 years, lumpectomy with at least a 5 mm margin, and ≤ 3 positive axillary nodes were eligible. APBI was delivered by 3D-CRT at a dose of 38.

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Background And Purpose: Definitive radiotherapy for patients with scalp angiosarcoma has a poor prognosis, often resulting in severe skin adverse events. Additionally, malignant melanoma is known for its radioresistant nature. Boron neutron capture therapy (BNCT) may address these challenges due to the high uptake capacity of boron drugs in these cancer types.

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The influence of metabolic dysfunction-associated steatotic liver disease (MASLD) on gallbladder polyp development in both sexes remains elusive. Therefore, to clarify the role of MASLD in gallbladder polyp development, we investigated the longitudinal association between MASLD and gallbladder polyps. In this observational study, we included 5,527 gallbladder polyp-free patients who underwent > 2 health check-ups over > 2 years.

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Background: The relationships between alcohol consumption, cardiometabolic factors, and liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease and those with metabolic dysfunction and alcohol-associated liver disease remain unclear.

Aims: To investigate the longitudinal associations among alcohol consumption, cardiometabolic factors, and liver fibrosis in patients with these two liver diseases.

Methods: This observational cohort study included 1866 patients with metabolic dysfunction-associated steatotic liver disease and 521 patients with metabolic dysfunction and alcohol-associated liver disease who underwent > two health checkups over >2 years.

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Article Synopsis
  • The study focuses on using a state-of-the-art MRI-guided linear accelerator (MR-LINAC) system to enhance the precision and safety of radiation therapy for patients with localized prostate cancer.
  • It involves a single-arm confirmatory study assessing the effects of ultra-hypofractionated radiation (26 Gy in 2 fractions) on patients with low to intermediate risk of prostate cancer, with the primary endpoint being acute urinary tract adverse events within 90 days of treatment.
  • Ethical considerations are paramount, with the study adhering to Japanese medical guidelines and ethical standards, and results will be published in a peer-reviewed journal and presented at an international conference.
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This study aimed to identify the required capabilities and workload of medical staff in accelerator-based boron neutron capture therapy (BNCT). From August to September 2022, a questionnaire related to the capabilities and workload in the accelerator-based BNCT was administered to 12 physicians, 7 medical physicists and 7 radiological technologists engaged in BNCT and 6 other medical physicists who were not engaged in BNCT to compare the results acquired by those engaged in BNCT. Only 6-21% of patients referred for BNCT received it.

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Retinal neurodegeneration, characterized by retinal ganglion cell (RGC) death, is a leading cause of vision impairment and loss in blind diseases, such as glaucoma. Müller cells play crucial roles in maintaining retinal homeostasis. Thus, dysfunction of Müller cells has been implicated as one of the causes of retinal diseases.

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  • The study evaluated how the introduction of durvalumab impacted the duration and tapering of corticosteroid therapy in patients with pneumonitis following chemoradiotherapy for lung cancer.
  • It analyzed medical records of 235 patients, revealing that those treated with durvalumab had longer corticosteroid therapy durations (17 weeks) and more frequent pneumonitis relapses compared to those who weren't (7 weeks and fewer relapses).
  • The findings suggest durvalumab complicates corticosteroid management for pneumonitis, providing insights for better patient care and clinical practice.
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  • In a study analyzing Japanese patients' attitudes towards ultra-hypofractionated (UHF) radiation therapy for early-stage breast cancer, it was found that this treatment is becoming the standard in Europe due to its effectiveness and low risk of complications.
  • The survey, conducted across 13 facilities, involved 247 patients who rated their enthusiasm for UHF on a scale of 0-10, with 69% rating it 6 or higher and 45% giving it a perfect score.
  • Most patients prioritized treatment efficacy (89%), while breast appearance after treatment was the least important factor for 53% of respondents, indicating a strong support for the UHF approach.
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Background: To protect the rectum and bladder from high dose exposure, the Japanese guidelines for managing uterine cervical carcinoma recommend pelvic irradiation with central shielding (CS). Conversely, the European Society for Radiotherapy and Oncology (ESTRO) and the American Brachytherapy Society (ABS) guidelines recommend delivering ≥85 Gy to high-risk clinical target volume D (CTV D). In this study, we investigated whether a gel spacer can enable the safe delivery of the ESTRO/ABS-recommended doses to the target while observing dose constraints for the OARs without using CS in external beam radiation therapy (EBRT).

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Background: The optimal strategy for cervical advanced esophageal cancer remains controversial in terms of oncologic outcome as well as vocal and swallowing function. Recently, in East Asian countries, neoadjuvant chemotherapy (NAC) has been a standard strategy for advanced esophageal cancer.

Methods: This study included 37 patients who underwent NAC, and 33 patients who underwent definitive chemoradiation therapy (dCRT) as larynx-preserving treatment for locally advanced cervical esophageal cancer from 2016 to 2021.

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Accelerator-based boron neutron capture therapy (BNCT) systems employing a solid-state lithium target indicated the reduction of neutron flux over the lifetime of a target, and its reduction could represent the neutron flux model. This study proposes a novel compensatory approach for delivering the required neutron fluence and validates its clinical applicability. The proposed approach relies on the neutron flux model and the cumulative sum of real-time measurements of proton charges.

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Article Synopsis
  • A study was conducted to compare the effectiveness of two types of spacers, hyaluronic acid (HA) and hydrogel spacer (HS), in reducing rectal toxicity during prostate cancer radiotherapy.
  • The study involved 38 patients, with HS and HA impacting different doses of radiation to the rectum, demonstrating that HA provided a significantly lower dose compared to HS.
  • The findings suggest that HA not only reduces rectal radiation exposure more effectively but also has better spatial expansion capabilities, indicating its potential as a preferred option over HS.
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  • The study examined how alcohol consumption affects the development and remission of metabolic dysfunction-associated fatty liver disease (MAFLD) in a cohort of 6,349 patients over more than two years.
  • Findings showed that while moderate alcohol intake didn't significantly influence MAFLD development, high levels of consumption did increase risks, particularly in men and women.
  • The research concluded that reducing or stopping alcohol intake is important to prevent liver fibrosis, even for those who have achieved remission from MAFLD.
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Activation of adenosine monophosphate (AMP)-activated protein kinase (AMPK) pathway protects against N-methyl-D-aspartic acid (NMDA)-induced excitotoxic retinal injury. AMPK activation enhances fatty acid metabolism and ketone body synthesis. Ketone bodies are transported into neurons by monocarboxylate transporters (MCTs) and exert neuroprotective effects.

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The heart utilizes glucose and its metabolites as both energy sources and building blocks for cardiac growth and survival under both physiological and pathophysiological conditions. YAP/TAZ, transcriptional co-activators of the Hippo pathway, are key regulators of cell proliferation, survival, and metabolism in many cell types. Increasing lines of evidence suggest that the Hippo-YAP/TAZ signaling pathway is involved in the regulation of both physiological and pathophysiological processes in the heart.

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Objective: This study evaluated the prognostic impact of the quality of dose distribution using dosiomics in patients with prostate cancer, stratified by pretreatment prostate-specific antigen (PSA) levels and Gleason grade (GG) group.

Methods: A total of 721 patients (Japanese Foundation for Cancer Research [JFCR] cohort: N = 489 and Tokyo Radiation Oncology Clinic [TROC] cohort: N = 232) with localized prostate cancer treated by intensity-modulated radiation therapy were enrolled. Two predictive dosiomic features for biochemical recurrence (BCR) were selected and patients were divided into certain groups stratified by pretreatment PSA levels and GG.

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Article Synopsis
  • * A 73-year-old woman with cervical cancer received targeted radiation treatment, where traditional methods fell short due to the proximity of her sigmoid colon, necessitating the injection of hydrogel into the meso-sigmoid.
  • * Results showed that using the hydrogel spacer successfully decreased the radiation dose to the sigmoid colon while still effectively targeting the high-risk areas of cancer, suggesting it as a viable technique for similar cases.
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Background: Melanoma brain metastasis (MBM) has a poor prognosis, although recent treatments, including immune checkpoint inhibitors and targeted therapy, have improved the prognosis. However, these systemic therapies have been reported to be less efficient for Asian patients. We investigated the survival of Asian patients with MBM and the effectiveness of systemic therapies.

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Article Synopsis
  • Radiation therapy can cause late adverse events due to difficulties in adhering to dose constraints for normal tissue, with spacers potentially reducing radiation exposure to surrounding healthy tissues during gynecologic brachytherapy.
  • Variability in tissue resistance affects the placement of spacers, with different tissues offering unique characteristics that can be utilized in surgical procedures, such as pelvic organ prolapse surgery and radical hysterectomies.
  • Effective spacer injection can improve patient safety and therapy effectiveness, requiring precision and proper anatomical understanding during administration.
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Article Synopsis
  • This study presents the first case of using a linear accelerator-based boron neutron capture therapy (BNCT) system to treat a patient with cutaneous malignant melanoma in a clinical trial that started in November 2019.
  • A patient with a localized melanoma who opted out of surgery and chemotherapy received BNCT after being administered boronophenylalanine (BPA), leading to a gradual improvement in their condition over 12 months.
  • While the patient experienced some mild side effects, there were no serious adverse events, indicating that accelerator-based BNCT could be a promising new treatment option for this type of cancer.
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