Details of a Researcher - NANASHIMA Atsushi

Spatiotemporal expression of HMGB2 regulates cell proliferation and hepatocyte size during liver regeneration Reviewed

Yano Koichi, Choijookhuu Narantsog, Ikenoue Makoto, Fidya, Fukaya Tomohiro, Sato Katsuaki, Lee Deokcheol, Taniguchi Noboru, Chosa Etsuo, Nanashima Atsushi, Hishikawa Yoshitaka

Scientific Reports 12 ( 1 ) 11962 2022.7

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

Liver regeneration is an extraordinarily complex process involving a variety of factors; however, the role of chromatin protein in hepatocyte proliferation is largely unknown. In this study, we investigated the functional role of high-mobility group box 2 (HMGB2), a chromatin protein in liver regeneration using wild-type and HMGB2-knockout (KO) mice. Liver tissues were sampled after 70% partial hepatectomy (PHx), and analyzed by immunohistochemistry, western blotting and flow cytometry using various markers of cell proliferation. In WT mice, hepatocyte proliferation was strongly correlated with the spatiotemporal expression of HMGB2; however, cell proliferation was significantly delayed in hepatocytes of HMGB2-KO mice. Quantitative PCR demonstrated that cyclin D1 and cyclin B1 mRNAs were significantly decreased in HMGB2-KO mice livers. Interestingly, hepatocyte size was significantly larger in HMGB2-KO mice at 36–72 h after PHx, and these results suggest that hepatocyte hypertrophy appeared in parallel with delayed cell proliferation. In vitro experiments demonstrated that cell proliferation was significantly decreased in HMGB2-KO cells. A significant delay in cell proliferation was also found in HMGB2-siRNA transfected cells. In summary, spatiotemporal expression of HMGB2 is important for regulation of hepatocyte proliferation and cell size during liver regeneration.

DOI： 10.1038/s41598-022-16258-4

Laparoscopic dome resection for pediatric nonparasitic huge splenic cyst safely performed using indocyanine green fluorescence and percutaneous needle grasper Reviewed

Masuya, R., Nakame, K., Tahira, K., Kai, K., Hamada, T., Yano, K., Imamura, N., Hiyoshi, M., Nanashima, A. and Satoshi Ieiri

Asian Journal of Endoscopic Surgery 15 ( 3 ) 693 - 696 2022.7

Language：English Publishing type：Case report Publisher：Asian journal of endoscopic surgery

INTRODUCTION: In recent years, dome resection, which preserves the splenic immunological function, has been the primary technique used to treat splenic cysts. We herein report a surgical technique using a needle grasper and indocyanine green (ICG) fluorescence to perform dome resection of a huge nonparasitic splenic cyst in a pediatric patient. PATIENT AND SURGICAL TECHNIQUE: A 13-year-old girl was incidentally diagnosed with a splenic cyst during follow-up for scoliosis. Abdominal enhanced computed tomography (CT) showed a 17 × 14 × 14 cm unifocal cyst. Laparoscopic dome resection was planned. The intraoperative findings showed that the spleen was distended, but there was no apparent prominence of the thin cyst wall on the surface of the spleen. An ICG fluorescence camera overlay revealed poor coloration in the thinning area. We punctured the area and aspirated the cyst contents. We grasped the cyst wall with a percutaneous needle grasper and dissected the cyst wall with a vessel sealing system. We placed anti-adhesion agent at the dissection line to prevent recurrence. DISCUSSION: ICG fluorescence was useful for identifying the thinning area of a splenic cyst. The use of a percutaneous needle grasper facilitated the performance of dome resection of a huge splenic cyst in a pediatric patient with minimal invasiveness and an improved cosmetic outcome.

DOI： 10.1111/ases.13052

Relationship of immunonutritional factor with changes in liver volume after portal vein embolization Reviewed

Nanashima Atsushi, Hiyoshi Masahide, Imamura Naoya, Hamada Takeomi, Kai Kengo, Tanoue Yukinori, Yano Koichi, Kitamura Eiji, Suzuki Yasuto, Tahira Kousei, Kawano Fumiya, Nagayasu Takeshi

Surgery Open Science 9 117 - 124 2022.6

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1016/j.sopen.2022.05.012

Using indocyanine green fluorescence in laparoscopic surgery to identify and preserve rare branching of the right hepatic artery in pediatric congenital biliary dilatation Reviewed

Masuya, R., Matsukubo, M., Nakame, K., Kai, K., Hamada, T., Yano, K., Imamura, N., Hiyoshi, M., Nanashima, A. and Ieiri S.

Surgery Today 82 ( 10 ) 1510 - 1513 2022.5

Language：English Publishing type：Case report Publisher：Surgery Today

We describe a laparoscopic surgical technique using indocyanine green (ICG) fluorescence to identify and preserve rare arterial branching associated with pediatric congenital biliary dilatation. Congenital biliary dilatation with pancreaticobiliary maljunction was diagnosed in a 9-year-old girl, who presented with upper abdominal pain. Abdominal enhanced computed tomography (CT) showed that the accessory right hepatic artery (aRHA) branched from the posterior superior pancreaticoduodenal artery (PSPDA) and flowed through the right aspect of the dilated common bile duct (CBD) directly into the right lobe of the liver. We performed laparoscopic dilated biliary duct resection and hepaticojejunostomy, administering ICG intravenously, at a dose of 0.6 mg/kg. The ICG fluorescence overlay mode showed an aRHA running along the right side of the dilated CBD. The aRHA was dissected from the CBD without injury. After finishing the anastomosis, the beating of the aRHA was preserved, confirming that blood flow had been maintained.

DOI： 10.1007/s00595-022-02516-5

Impact of the number of board-certified pediatric surgeons per pediatric population on the outcomes of laparoscopic fundoplication for neurologically impaired patients Reviewed

Masuya, R., Muto, M., Nakame, K., Murakami, M., Sugita, K., Yano, K., Onishi, S., Harumatsu, T., Yamada, K., Yamada, W., Matsukubo, M., Kaji, T., Nanashima, A. and Ieiri, S.

Journal of Laparoendoscopic & Advanced Surgical Techniques 32 ( 5 ) 571 - 575 2022.5

Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Laparoendoscopic and Advanced Surgical Techniques

Background and Aim: The distribution of board-certified pediatric surgeons (BCPSs) in Japan is highly biased. While Prefecture M has one of the smallest numbers of BCPSs per pediatric population, neighboring Prefecture K has one of the largest numbers of BCPSs per pediatric population. We examined the effect of BCPSs population on laparoscopic surgery and postoperative management and outcomes. Materials and Methods: We compared postoperative duration to full-dose enteral nutrition, postoperative hospital stay, and complications of neurologically impaired patients who underwent laparoscopic fundoplication in two prefectures from 2006 to 2019. Results: Laparoscopic fundoplication was performed in 17 patients in Prefecture M and 63 in K. The mean operative time was 248.8 ± 79.9 minutes in Prefecture M and 260.8 ± 94.8 in K (P = .64). The median number of days to full-dose enteral nutrition was 11.5 in Prefecture M and 10 in K (P = .29). The median postoperative hospital stay was 14 days in Prefecture M and 15 days in K (P = .38). Postoperative complications occurred in 7 cases in Prefecture M and in 10 in K. The incidence was significantly higher in Prefecture M than in K (P = .041). Conclusion: Areas with insufficient numbers of BCPSs have a higher risk of complications in laparoscopic surgery than areas with sufficient numbers.

DOI： 10.1089/lap.2021.0713

Curative remnant total pancreatectomy for recurrent pancreatic acinar cell carcinoma: A case report Reviewed

Hiyoshi Masahide, Kai Kengo, Hamada Takeomi, Nanashima Atsushi, Yano Koichi

International Journal of Surgery Case Reports 94 107091 - 107091 2022.5

Authorship：Last author,　Corresponding author Language：English Publishing type：Case report

DOI： 10.1016/j.ijscr.2022.107091

Integrin α6A (ITGA6A)-type Splice Variant in Extracellular Vesicles Has a Potential as a Novel Marker of the Early Recurrence of Pancreatic Cancer Reviewed

弓部置換術後の大動脈食道瘻に対し，分割的に食道切除術と再建，大網充填術を施行し救命した1例 Reviewed

内勢由佳子，田代耕盛，宗像　駿，北村英嗣，濵田朗子，河野文彰，武野慎祐，森　晃佑，阪口修平，石井廣人，古川貢之，七島篤志

Japanese Journal of Acute Care Surgery 12 ( 1 ) 95 - 99 2022.4

Authorship：Last author Language：Japanese Publishing type：Case report

Asada T., Nakahata S., Fauzi Y.R., Ichikawa T., Inoue K., Shibata N., Fujii Y., Imamura N., Hiyoshi M., Nanashima A., Morishita K.

Anticancer Research 42 ( 4 ) 1763 - 1775 2022.4

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

Background/Aim: Pancreatic ductal adenocarcinoma (PDAC) is one of the most common cancers worldwide, with a poor prognosis. Owing to the difficulty of early diagnosis, the aim of this study was to isolate biomarkers from extracellular vesicles (EVs) that can lead to early diagnosis. Materials and Methods: EVs in the culture supernatant were isolated from a pancreatic cancer cell line (PK-1) and expanded by using two-dimensional gel electrophoresis, and protein identification from each spot was performed by using matrix-assisted laser desorption ionization mass spectrometry. The identified proteins were classified and compared with previously reported results for EVs from murine pancreatic cancer PAN02 cells, and their expression specificity was examined using PDAC cell lines and patient-derived PDAC tissues. In addition, the significance of selected biomarker(s) was examined based on the changes in biomarkers in the blood EVs of PDAC patients after surgery. Results: We found that the ITGA6A splice variant was predominantly expressed in several pancreatic cancer cell lines and blood EVs from patients with PDAC, whereas the ITGA6B splice variant was predominantly expressed in EVs from the blood of normal volunteers. In the expression pattern of ITGA6 in EVs from blood samples of two PDAC patients before and after resection surgery, the expression of ITGA6A in EVs significantly decreased after surgery and increased several months before clinical recurrence. Furthermore, the increased expression of ITGA6A in EVs occurred much earlier than that of CA19-9. Conclusion: Determination of ITGA6A expression in blood EVs in PDAC patients could be a useful blood marker for the early diagnosis of PDAC recurrence.

DOI： 10.21873/anticanres.15653

Biliary atresia: graft-versus-host disease with maternal microchimerism as an etiopathogenesis Reviewed

Masuya R., Muraji T., Harumatsu T., Muto M., Nakame K., Nanashima A., Ieiri S.

Transfusion and Apheresis Science 61 ( 2 ) 103410 2022.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Transfusion and Apheresis Science

Biliary atresia (BA) is an inflammatory disease of the biliary system in newborns and infants. The etiology is largely unknown. Approximately half of BA patients require liver transplantation by 20 years of age, even after surgical correction due to progressive fibrosis of the liver. Regarding the disease mechanism, there is circumstantial evidence to support the hypothesis of graft-versus-host disease because of the existence of maternal cells in the liver (maternal microchimerism, MMC), histopathological similarity of the liver and an intense maternal response to the BA patient with mixed lymphocyte culture. Immune dysregulation with decreased Treg and increased Th1 and Th17 cells are the pathogenic features of BA, which are homologous to the pathogenic features of GvHD. Further elucidation of the etiopathogenetic mechanism of BA is warranted for development of new therapeutic strategies for native liver survival.

DOI： 10.1016/j.transci.2022.103410

Integrin α6A (ITGA6A)-type Splice Variant in Extracellular Vesicles Has a Potential as a Novel Marker of the Early Recurrence of Pancreatic Cancer

Asada T., Nakahata S., Fauzi Y.R., Ichikawa T., Inoue K., Shibata N., Fujii Y., Imamura N., Hiyoshi M., Nanashima A., Morishita K.

Anticancer Research 42 ( 4 ) 1763 - 1775 2022.4

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

DOI： 10.21873/anticanres.15653

Biliary atresia: graft-versus-host disease with maternal microchimerism as an etiopathogenesis Reviewed

Masuya R., Muraji T., Harumatsu T., Muto M., Nakame K., Nanashima A., Ieiri S.

Transfusion and Apheresis Science 61 ( 2 ) 103410 - 103410 2022.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Transfusion and Apheresis Science

DOI： 10.1016/j.transci.2022.103410

Knowledge survey regarding blast wound education of student doctors at a local academic medical university in Japan Reviewed

開腹手術を必要とした経肛門直腸異物の1例 Reviewed

樋口和宏，末田秀人，佐野浩一郎，真方寿人，市来伸彦，七島篤志

宮崎県医師会医学会誌 46 ( 1 ) 42 - 45 2022.3

Authorship：Last author Language：Japanese Publishing type：Case report

術後1年および5年無再発生存中の大腸MiNENの2例 Reviewed

市来伸彦，池田拓人，市原明子，濵田朗子，大田勇輔，七島篤志

日本臨床外科学会雑誌 83 ( 3 ) 542 - 549 2022.3

Authorship：Last author,　Corresponding author Language：Japanese Publishing type：Research paper (scientific journal)

Kawano F., Munakata S., Tashiro K., Ikenoue M., Furukawa K., Ochiai H., Nakamura K., Nanashima A.

Turkish Journal of Surgery 38 ( 1 ) 74 - 80 2022.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Turkish Journal of Surgery

Objective: To improve knowledge about blast injury for medical student doctors or surgeons. In the modern uncertain era, education and training programs for blast injuries for medical student doctors or surgeons are recently necessary worldwide. Material and Methods: To understand primary corresponding ability to treat blast injuries, leading to improvement of the trauma education curriculum, a retrospective study by a knowledge survey was performed between 2018 and 2019. The subject had the title of Student Doctor (SD) at university. Results: The answers of 183 participants who answered the interview questionnaire with 16 questions were summarized. Although most SDs received basic lectures for trauma medicine and majority of SDs knew about mass casualty incidents and primary treatment, the existence of knowledge on soft targets is limited. One-fourth of the SDs knew the characteristics of blast wounds. Most SDs understood priority triage for a conscious person with massive bleeding from a limb with hemostasis to save lives. The 17% selected cardiopulmonary resuscitation first and 72% of SDs could explain hemorrhagic shock; however, only four could explain adequate hemostatic procedures. Most had no interest regarding necessity of their knowledge in the field of serious blast trauma wounds. Conclusion: Experience in trauma surgery training from stages in SDs and authorized education are important for raising students’ knowledge of unexpected serious blast incidents.

DOI： 10.47717/TURKJSURG.2022.5537

Queries regarding the optimal indication of infrahepatic inferior vena cava clamping and proposal for examining the hepatic venous pressures or accompanied Trendelenburg position to improve this procedure Reviewed

Nanashima A.

Journal of Hepato-Biliary-Pancreatic Sciences 29 ( 3 ) e15 - e16 2022.3

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Hepato-Biliary-Pancreatic Sciences

DOI： 10.1002/jhbp.1042

Usefulness of intraoperative contrast-enhanced ultrasonography in laparoscopic enucleation of small pancreatic metastases from renal cell carcinoma: A case report. Reviewed

Kai K, Imamura N, Hiyoshi M, Hamada T, Uchise Y, Hatada H, Kawakami H, Mukai S, Kamoto T, Nanashima A

Asian Journal of Endoscopic Surgery 15 ( 1 ) 211 - 215 2022.1

Authorship：Last author,　Corresponding author Language：English Publishing type：Case report Publisher：Asian journal of endoscopic surgery

Pancreatic metastasis from renal cell carcinoma (RCC) is relatively rare. Surgical resection of the lesion is recommended if no residual tumor remains. Although there is no clear standard for surgical procedures, enucleation can be considered for small lesions. Lesion identification is important for enucleation, and contrast-enhanced ultrasound which takes advantage of the characteristics of hypervascular lesions was useful in a 68-year-old woman who underwent a left nephrectomy for RCC 11 years ago that was pathologically diagnosed as clear cell carcinoma. Recent computed tomography checkup showed a hypervascular tumor of 6 mm in the uncinated process and 10 mm in the pancreatic tail. Endoscopic ultrasonography-guided fine-needle aspiration was performed for the tail lesion, a diagnosis of clear cell carcinoma was made, and laparoscopic enucleation of the pancreatic tumors was performed aided by intraoperative contrast-enhanced ultrasound. The postoperative course was uneventful, and no pancreatic fistula occurred.

DOI： 10.1111/ases.12974

An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time.

Inomata M, Kai K, Ikeda T, Ichihara A, Masuda R, Kiwaki T, Tanaka H, Kataoka H, Nanashima A

Surgical case reports 7 ( 1 ) 258 2021.12

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

DOI： 10.1186/s40792-021-01337-x

Preoperative Prognostic Nutritional Index is a significant predictive factor for posthepatectomy bile leakage Reviewed International journal

Nanashima A, Hiyoshi M, Imamura N, Yano K, Hamada T, Kai K, Nishida T, Uchise Y, Sakamoto R, Inomata M.

Annals of Hepato-Biliary-Pancreatic Surgery 25 ( 4 ) 477 - 484 2021.11

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：Annals of Hepato-Biliary-Pancreatic Surgery

Backgrounds/Aims: It is known that preoperative nutritional status can influence patient outcomes after hepatectomy. Prognostic Nutritional Index (PNI) is a useful parameter to reflect patient outcomes undergoing gastro-intestinal surgery. The aim of this study was to retrospectively evaluate relationships of nutritional parameters, demographics, and surgical records with postoperative outcomes in a cohort study. Methods: Curative hepatectomy was performed for 182 patients at the University of Miyazaki between 2015 and 2018. Each preoperative level of albumin, prealbumin, lymphocyte, total cholesterol, or the comprehensively calculated Onodera’s PNI was examined as a nutritional parameter. Results: The mean PNI was 39.6 ± 5.1, with PNI below 40 observed in 91 (50.0%) patients. Nutritional parameters were not different among patients with various liver diseases. Serum albumin or prealbumin level was significantly correlated with each hepatic parameter (p < 0.01). Prealbumin and total cholesterol levels were significantly correlated with postoperative prothrombin activity (p < 0.05). Albumin or prealbumin levels and PNI were significantly lower in patients with posthepatectomy complications, particularly bile leakage in comparison those without such complications (p < 0.05). Multiple logistic analysis showed that albumin level was an independent risk factor for complications after hepatectomy (risk ratio [RR]: 1.33) and that lymphocyte count was an independent risk factor for bile leakage (RR: 1.28) (p < 0.05). The cut-off level of albumin was approximately 3.8 mg/dL and that of lymphocyte count was 1,320/mm3. Conclusions: Preoperative PNI reflected perioperative liver functional status. It was a predictive parameter for postoperative complications, particularly biliary leakage.

DOI： 10.14701/ahbps.2021.25.4.477