Faculty Profiles - NAKAO Atsunori

血栓溶解療法中に腹腔内出血が出現した経口避妊薬内服患者の一症例

寺嶋真理子, 中尾篤典, 橋本篤徳, 満保直美, 高杉遥, 村上裕亮, 山田勇, 小谷穣治

日本集中治療医学会雑誌 21 ( Suppl. ) [DP - 5] 2014.1

Role of endogenous IL-18 in the lung during endotoxin-induced systemic inflammation. Reviewed International journal

Miki Takahara, Michiko Aoyama-Ishikawa, Katsuhito Shuno, Chisato Yamauhi, Makoto Miyoshi, Noriaki Maeshige, Makoto Usami, Taihei Yamada, Takaaki Osako, Atsunori Nakao, Joji Kotani

Acute medicine & surgery 1 ( 1 ) 23 - 30 2014.1

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

Background: Overactivated neutrophils are causes of acute lung injury, which is a major clinical problem with significant morbidity and mortality in sepsis. Serum interleukin (IL)-18 levels correspond to severity of systemic inflammation. Aim: To elucidate the roles of endogenous IL-18 in lung injury during endotoxin-induced systemic inflammation. Methods: Wild-type (WT) and IL-18 gene knockout (KO) mice were injected with lipopolysaccharide (40 mg/kg) intraperitoneally and killed. Lungs were collected at 0 and 12 h to assess mRNA for intercellular adhesion molecule (ICAM)-1, inducible nitric oxide synthase, myeloperoxidase, immunohistochemistry (cleaved caspase-3, 8-hydroxy-2-deoxyguanosine), and wet/dry ratio. Blood was collected at 0, 1, 12, 18, and 24 h to assess plasma cytokine levels. Results: The survival rates at 24 h were approximately 43% and 76% in the WT and KO mice, respectively. Plasma IL-18 levels were induced time-dependently only in the WT mice. Plasma interferon-γ levels were significantly higher in the WT than in the KO mice at 12 h, but IL-6 and tumor necrosis factor-α levels did not differ between the WT and KO mice. At 12 h, the WT mice showed higher myeloperoxidase activity (P < 0.05), ICAM-1, and wet/dry ratios than KO mice. Cleaved caspase-3 positive neutrophils, which migrated in the lung interstitium, were lower in WT mice than in KO mice. Conclusions: Endogenous IL-18 induced neutrophil accumulation, accompanied by induction of ICAM-1 expression, inhibition of neutrophil apoptosis, and increased inducible nitric oxide synthase-induced oxidative tissue injury in the lung, leading to lung edema and poor outcome during endotoxemia.

DOI： 10.1002/ams2.6

J-GLOBAL

Can carbon monoxide-poisoned victims be organ donors? International journal

Noritomo Fujisaki, Atsunori Nakao, Takaaki Osako, Takeshi Nishimura, Taihei Yamada, Keisuke Kohama, Hiroyuki Sakata, Michiko Ishikawa-Aoyama, Joji Kotani

Medical gas research 4 13 - 13 2014

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

The increasing demand for organ allografts to treat end-stage organ failure has driven changes in traditional donor criteria. Patients who have succumbed to carbon monoxide (CO) poisoning, a common cause of toxicological mortality, are usually rejected as organ donors. To fulfill the increasing demand, selection criteria must be expanded to include CO-poisoned donors. However, the use of allografts exposed to high CO concentrations is still under debate. Basic research and literature review data suggest that patients with brain death caused by CO poisoning should be considered appropriate organ donors. Accepting organs from CO-poisoned victims could increase the number of potential donors and lower the death rate of patients on the waiting lists. This review and reported cases may increase awareness among emergency department physicians, as well as transplant teams, that patients dying of CO exposure may be acceptable organ donors.

DOI： 10.1186/2045-9912-4-13

Can carbon monoxide-poisoned victims be organ donors?

Noritomo Fujisaki, Atsunori Nakao, Takaaki Osako, Takeshi Nishimura, Taihei Yamada, Keisuke Kohama, Hiroyuki Sakata, Michiko Ishikawa-Aoyama, Joji Kotani

Medical Gas Research 4 ( 1 ) 13 - 13 2014

Gastrointestinal symptoms and food/nutrition concerns after the great east japan earthquake in march 2011: Survey of evacuees in a temporary shelter Reviewed

Tomoko Inoue, Atsunori Nakao, Kazutoshi Kuboyama, Atsunori Hashimoto, Motomaru Masutani, Takahiro Ueda, Joji Kotani

Prehospital and Disaster Medicine 29 ( 3 ) 303 - 306 2014

Language：English Publishing type：Research paper (scientific journal) Publisher：Cambridge University Press

On March 11, 2011, a 9.1 magnitude earthquake occurred in the eastern Pacific Ocean off the coast of northern Japan. A resulting tsunami struck the Japan Pacific coast, causing &gt
20,000 deaths, injuries and missing persons. Survivors' post-tsunami health and nutritional status were surveyed one month after the disaster in a school shelter in Ishinomaki City. Hyogo College of Medicine's disaster relief team observations and survivors' questionnaires were used to assess the disaster's effects on survivors' lifestyles and gastrointestinal symptoms while residing in temporary shelters. Of 236 disaster evacuees 9-88 years of age (mean age 52 years), 23% lost weight and 28% reported decreased food intake one month after the earthquake. Up to 25% of the participants presented with gastrointestinal symptoms, including constipation (10%), appetite loss (6.4%), vomiting (6.4%), and nausea (2.1%). Although the victims preferred more vegetables (44%) or fruit (33%), most food aid received, such as rice balls or bread, was carbohydrate-based, possibly because of easy provision and abundance in emergency food pantries. The authors asked the volunteers and the Japan Self-Defense Forces to provide a more balanced diet, including vegetables and fruit. Consumption of imbalanced diets may have caused more gastrointestinal symptoms for the survivors. Because of the victims' hesitation to request more balanced diets, and because of poorly controlled existing chronic disease and mental stress, professional public health providers should assure emergency food nutrition after disasters.

DOI： 10.1017/S1049023X14000533

Scopus

急性虫垂炎症状を呈し生前には診断困難であった劇症型アメーバ赤痢の一例

開放性気胸合併フレイルチェストに対し、肋骨ピンによる観血的骨接合術が奏功した1症例

寺嶋真理子, 山田太平, 橋本篤徳, 中尾篤典, 山田勇, 小谷穣治

日本Acute Care Surgery学会学術集会プログラム・抄録 5回 53 - 53 2013.11

満保直美, 寺嶋真理子, 橋本篤徳, 和田恭直, 山田勇, 中尾篤典, 小谷穣治

日本外科感染症学会雑誌 10 ( 5 ) 705 - 705 2013.10

敗血症性ショックを呈した、壊死性筋膜炎の1例

寺嶋真理子, 宮脇敦志, 満保直美, 中尾篤典, 橋本篤徳, 松田健一, 坂田寛之, 岡本彩那, 上田敬博, 小谷穣治

日本外科感染症学会雑誌 10 ( 5 ) 701 - 701 2013.10

Successful treatment of a 14-year-old patient with intestinal malrotation with laparoscopic Ladd procedure: case report and literature review. Reviewed International journal

Yuka Nakajima, Hiroyuki Sakata, Tomohiro Yamaguchi, Norichika Yoshie, Taihei Yamada, Takaaki Osako, Mariko Terashima, Naomi Mambo, Ryuta Saka, Satoko Nose, Takashi Sasaki, Hiroomi Okuyama, Atsunori Nakao, Joji Kotani

World journal of emergency surgery : WJES 8 ( 1 ) 19 - 19 2013.5

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

Midgut malrotation is an anomaly of intestinal rotation that occurs during fetal development and usually presents in the neonatal period. We present a rare case of malrotation in a 14-year-old patient who presented with cramping, generalized right abdominal pain, and vomiting for a duration of one day. A computed tomography abdominal scan and upper gastrointestinal contrast studies showed malrotation of the small bowel without volvulus. Laparoscopy revealed typical Ladd's bands and a distended flabby third and fourth duodenal portion extrinsically obstructing the misplaced duodeno-jejunal junction. The Ladd procedure, including widening of the mesenteric base and appendectomy, was performed. Symptoms completely resolved in a half-year follow up period. Patients with midgut malrotation may present with vague abdominal pain, intestinal obstruction, or intestinal ischemia. The laparoscopic Ladd procedure is feasible and safe, and it appears to be as effective as the standard open Ladd procedure in the diagnosis and treatment of teenage or adult patients with intestinal malrotation.

DOI： 10.1186/1749-7922-8-19

NOMI(非閉塞性腸管虚血症)に伴う結腸壊死を合併した重症急性膵炎の1例

山田勇, 寺嶋真理子, 橋本篤典, 中尾篤典, 上田敬博, 小谷穣治

日本外科系連合学会誌 38 ( 3 ) 693 - 693 2013.5

Hydrogen gas reduces hyperoxic lung injury via the Nrf2 pathway in vivo

Tomohiro Kawamura, Nobunao Wakabayashi, Norihisa Shigemura, Chien-Sheng Huang, Kosuke Masutani, Yugo Tanaka, Kentaro Noda, Ximei Peng, Toru Takahashi, Timothy R. Billiar, Meinoshin Okumura, Yoshiya Toyoda, Thomas W. Kensler, Atsunori Nakao

AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY 304 ( 10 ) L646 - L656 2013.5

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER PHYSIOLOGICAL SOC

Hyperoxic lung injury is a major concern in critically ill patients who receive high concentrations of oxygen to treat lung diseases. Successful abrogation of hyperoxic lung injury would have a huge impact on respiratory and critical care medicine. Hydrogen can be administered as a therapeutic medical gas. We recently demonstrated that inhaled hydrogen reduced transplant-induced lung injury and induced heme oxygenase (HO)-1. To determine whether hydrogen could reduce hyperoxic lung injury and investigate the underlying mechanisms, we randomly assigned rats to four experimental groups and administered the following gas mixtures for 60 h: 98% oxygen (hyperoxia), 2% nitrogen; 98% oxygen (hyperoxia), 2% hydrogen; 98% balanced air (normoxia), 2% nitrogen; and 98% balanced air (normoxia), 2% hydrogen. We examined lung function by blood gas analysis, extent of lung injury, and expression of HO-1. We also investigated the role of NF-E2-related factor (Nrf) 2, which regulates HO-1 expression, by examining the expression of Nrf2-dependent genes and the ability of hydrogen to reduce hyperoxic lung injury in Nrf2-deficient mice. Hydrogen treatment during exposure to hyperoxia significantly improved blood oxygenation, reduced inflammatory events, and induced HO-1 expression. Hydrogen did not mitigate hyperoxic lung injury or induce HO-1 in Nrf2-deficient mice. These findings indicate that hydrogen gas can ameliorate hyperoxic lung injury through induction of Nrf2-dependent genes, such as HO-1. The findings suggest a potentially novel and applicable solution to hyperoxic lung injury and provide new insight into the molecular mechanisms and actions of hydrogen.

DOI： 10.1152/ajplung.00164.2012

重症胸部外傷による呼吸不全に対し体外式肺補助(ECMO)管理した1症例

山田太平, 小谷穣治, 久保山一敏, 上田敬博, 尾迫貴章, 中島有香, 吉江範親, 松田健一, 中尾篤典, 寺嶋真理子, 小濱圭祐, 橋本篤徳, 満保直美

日本外傷学会雑誌 27 ( 2 ) 225 - 225 2013.4

肝損傷修復術後の腹腔内膿瘍がプレジェットにより遷延、十二指腸穿孔に至った一例

小濱圭祐, 寺嶋真理子, 橋本篤徳, 山田勇, 中尾篤典, 山田太平, 満保直美, 宮脇淳志, 久保山一敏, 小谷穣治

日本外傷学会雑誌 27 ( 2 ) 242 - 242 2013.4

Linezolid-induced lactic acidosis followed by severe hypophosphatemia after discontinuation of linezolid. Reviewed International journal

Atsushi Miyawaki, Takahiro Ueda, Atsunori Nakao, Masaru Adachi, Munehiko Ohya, Isamu Yamada, Yoshio Takesue, Joji Kotani

Surgical infections 14 ( 2 ) 229 - 30 2013.4

The effects of n-3 polyunsaturated fatty acid-rich total parenteral nutrition on neutrophil apoptosis in a rat endotoxemia Reviewed

Mariko Terashima, Michiko Aoyama-Ishikawa, Takahiro Ueda, Akifumi Hagi, Makoto Usami, Atsunori Nakao, Joji Kotani

JOURNAL OF CLINICAL BIOCHEMISTRY AND NUTRITION 52 ( 2 ) 154 - 159 2013.3

Language：English Publishing type：Research paper (scientific journal) Publisher：JOURNAL CLINICAL BIOCHEMISTRY & NUTRITION

Although recruited neutrophils function as first-line defense to remove bacteria, delayed apoptosis is implicated in persistent inflammation leading to organ injury. Leukotrien B-4, n-6 polyunsaturated fatty acids (PUFAs) product, is one of the mediators that delay neutrophil apoptosis. The mechanism of the beneficial effects of supplementation of fish oil-based long-chain n-3 PUFAs in parenteral nutrition for critically ill patients has not been fully understood. One possible mechanism is the less inflammatory n-3 PUFAs products can compete with proinflammatory n-6 PUFAs products for access to the enzymes. The aim of this study was to determine whether n-3 PUFA rich parenteral nutrition may alter the composition of fatty acids in the neutrophil membrane and restore delay of neutrophil apoptosis during endotoxin-induced systemic inflammation in rats. The animals in group 1 were treated with 20% Hicaliq NC-N in Neoparen-2 for three days. The animals in group 2 (referred to as n-6 PUFA-rich parenteral nutrition) were given parenteral nutrition solutions containing 20% soybean oil in Neoparen-2 (n-6/n-3 = 10). The animals in group 3 (referred to as n-3 PUFA-rich parenteral nutrition) were administered parenteral nutrition consisting of 10% soybean oil and 10% fish oil emulsion (n-6/n-3 = 1.3). The n-3/n-6 ratio of the neutrophil membrane was significantly increased in group 3 and was associated with restored lipopolysaccharide-delayed-apoptosis of neutrophils in bone marrow cells and increased production of leukotriene B-5 from peritoneal neutrophils stimulated by lipopolysaccharide. Our preliminary results showed that n-3 PUFA-rich parenteral nutrition regulated neutrophil apoptosis and prevented synthesis of pro-inflammatory eicosanoids, explaining the protective effects seen in the clinical setting.

DOI： 10.3164/jcbn.12-86

重症急性膵炎の集計から発覚した、難病疾患登録とDPC登録病名の盲点

橋本篤徳, 井上朋子, 山田太平, 小濱圭祐, 寺嶋真理子, 中尾篤典, 山田勇, 小谷穣治

日本腹部救急医学会雑誌 33 ( 2 ) 492 - 492 2013.2

Inhalation of carbon monoxide following resuscitation ameliorates hemorrhagic shock-induced lung injury Reviewed

Susumu Kawanishi, Toru Takahashi, Hiroshi Morimatsu, Hiroko Shimizu, Emiko Omori, Kenji Sato, Masaki Matsumi, Shigeru Maeda, Atsunori Nakao, Kiyoshi Morita

MOLECULAR MEDICINE REPORTS 7 ( 1 ) 3 - 10 2013.1

Language：English Publishing type：Research paper (scientific journal) Publisher：SPANDIDOS PUBL LTD

Even after successful resuscitation, hemorrhagic shock frequently causes pulmonary inflammation that induces acute lung injury (ALI). We previously demonstrated that when CO is inhaled at a low concentration both prior to and following hemorrhagic shock and resuscitation (HSR) it ameliorates HSR-induced ALI in rats due to its anti-inflammatory effects. In the present study, we administered CO to the same model of ALI only after resuscitation and examined whether it exerted a therapeutic effect without adverse events on HSR-induced ALI, since treatment of animals with CO prior to HSR did not prevent lung injury. HSR were induced by bleeding animals to achieve a mean arterial pressure of 30 mmHg for I h followed by resuscitation with the removed blood. HSR resulted in the upregulation of inflammatory gene expression and increased the rate of apoptotic cell death in the lungs. This was determined from an observed increase in the number of cells positive for transferase-mediated dUTP-fluorescein isothiocyanate (FITC), nick-end labeling staining and activated caspase-3. HSR also resulted in prominent histopathological damage, including congestion, edema, cellular infiltration and hemorrhage. By contrast, CO inhalation for 3 h following resuscitation significantly ameliorated these inflammatory events, demonstrated by reduced histological damage, inflammatory mediators and apoptotic cell death. The protective effects of CO against lung injury were notably associated with an increase in the protein expression level of peroxisome proliferator-activated receptor (PPAR)-gamma, an anti-inflammatory transcriptional regulator in the lung. Moreover, CO inhalation did not affect the hemodynamic status or tissue oxygenation during HSR. These findings suggest that inhalation of CO at a low concentration exerts a potent therapeutic effect against HSR-induced ALI and attenuates the inflammatory cascade by increasing PPAR-gamma protein expression.

DOI： 10.3892/mmr.2012.1173

Application of a first impression triage in the Japan railway west disaster. Reviewed

Atsunori Hashimoto, Takahiro Ueda, Kazutoshi Kuboyama, Taihei Yamada, Mariko Terashima, Atsushi Miyawaki, Atsunori Nakao, Joji Kotani

Acta medica Okayama 67 ( 3 ) 171 - 6 2013

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

On April 25, 2005, a Japanese express train derailed into a building, resulting in 107 deaths and 549 injuries. We used "First Impression Triage (FIT)", our new triage strategy based on general inspection and palpation without counting pulse/respiratory rates, and determined the feasibility of FIT in the chaotic situation of treating a large number of injured people in a brief time period. The subjects included 39 patients who required hospitalization among 113 victims transferred to our hospital. After initial assessment with FIT by an emergency physician, patients were retrospectively reassessed with the preexisting the modified Simple Triage and Rapid Treatment (START) methodology, based on Injury Severity Score, probability of survival, and ICU stay. FIT resulted in shorter waiting time for triage. FIT designations comprised 11 red (immediate), 28 yellow (delayed), while START assigned six to red and 32 to yellow. There were no statistical differences between FIT and START in the accuracy rate calculated by means of probability of survival and ICU stay. Overall validity and reliability of FIT determined by outcome assessment were similar to those of START. FIT would be a simple and accurate technique to quickly triage a large number of patients.

DOI： 10.18926/AMO/50410

Scopus

Lung transplantation in rats

Tomohiro Kawamura, Yugo Tanaka, Norihisa Shigemura, Yoshiya Toyoda, Atsunori Nakao

Experimental Organ Transplantation 159 - 173 2013

Language：English Publishing type：Part of collection (book) Publisher：Nova Science Publishers, Inc.

This chapter describes a unilateral, orthotopic lung transplantation (LTx) model using the cuff technique in rats. The advantage of this model over the suture technique includes a decrease in operation time, prevention of bleeding from the vascular anastomosis site, and shorter training period with stable outcomes. The rat LTx model has been proven valid for understanding physiological/pathological events occurring in lung grafts, as well as evaluating graft injuries due to inflammation or rejection, as seen in clinical lung transplant.&amp
copy 2013 Nova Science Publishers, Inc.

Scopus