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  1. Article ; Online: Rescue technique using a novel device delivery system for difficult endoscopic transpapillary gallbladder stenting.

    Nakahara, Kazunari / Sekine, Akihiro / Tateishi, Keisuke

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society

    2024  Volume 36, Issue 4, Page(s) 504–505

    MeSH term(s) Humans ; Gallbladder ; Endoscopy ; Endoscopy, Digestive System/methods ; Stents ; Drainage/methods ; Cholecystitis, Acute
    Language English
    Publishing date 2024-02-01
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1171589-3
    ISSN 1443-1661 ; 0915-5635
    ISSN (online) 1443-1661
    ISSN 0915-5635
    DOI 10.1111/den.14763
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    Zs.A 3854: Show issues Location:
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  2. Article ; Online: Double novel integrated outside biliary stent and nasobiliary drainage catheter system placement for hilar biliary stricture.

    Sekine, Akihiro / Nakahara, Kazunari / Tateishi, Keisuke

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society

    2024  

    Language English
    Publishing date 2024-04-04
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1171589-3
    ISSN 1443-1661 ; 0915-5635
    ISSN (online) 1443-1661
    ISSN 0915-5635
    DOI 10.1111/den.14799
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  3. Article ; Online: Asymmetric Skin Temperature in Wallenberg Syndrome.

    Nakahara, Keiichi / Nakajima, Makoto

    Neurology India

    2022  Volume 70, Issue 5, Page(s) 2326–2327

    MeSH term(s) Humans ; Lateral Medullary Syndrome/complications ; Lateral Medullary Syndrome/diagnostic imaging ; Skin Temperature
    Language English
    Publishing date 2022-11-09
    Publishing country India
    Document type Journal Article
    ZDB-ID 415522-1
    ISSN 1998-4022 ; 0028-3886
    ISSN (online) 1998-4022
    ISSN 0028-3886
    DOI 10.4103/0028-3886.359284
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  4. Article: [Monitoring for Spine and Spinal Cord Surgery].

    Hashimoto, Aya / Nakahara, Keiko / Hattori, Gohsuke / Morioka, Motohiro

    No shinkei geka. Neurological surgery

    2023  Volume 51, Issue 3, Page(s) 507–516

    Abstract: Injuries of the spine and nerve root may occur during spine or spinal cord surgery, which can induce serious neurological deficits. Intraoperative monitoring plays important roles in monitoring the nerve function in various surgical manipulations, such ... ...

    Abstract Injuries of the spine and nerve root may occur during spine or spinal cord surgery, which can induce serious neurological deficits. Intraoperative monitoring plays important roles in monitoring the nerve function in various surgical manipulations, such as surgical positioning, mechanical compression, and tumor removal. This monitoring issues a warning to neuronal injuries at an early stage, and surgeons are able to prevent postoperative complications. The appropriate monitoring systems should be chosen with compatibility to the disease, surgical procedure, and lesion localization. The team should share the significance of monitoring and understand the timing of stimulation to perform a safe surgery. In this paper, we overview various intraoperative monitoring techniques and pitfalls in spine and spinal cord surgeries based on cases from our hospital.
    MeSH term(s) Humans ; Spine/surgery ; Monitoring, Intraoperative/methods ; Neurosurgical Procedures ; Postoperative Complications/prevention & control ; Postoperative Complications/surgery ; Spinal Cord/surgery ; Evoked Potentials, Motor/physiology
    Language Japanese
    Publishing date 2023-05-22
    Publishing country Japan
    Document type English Abstract ; Journal Article
    ZDB-ID 197053-7
    ISSN 1882-1251 ; 0301-2603
    ISSN (online) 1882-1251
    ISSN 0301-2603
    DOI 10.11477/mf.1436204775
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  5. Article: [Thoracoscopic Resection of Schwannoma Using Intraoperative Neurophysiological Monitoring: Report of a Case].

    Sakai, Emi / Nakahara, Kazuki / Kina, Satsuki / Miyanaga, Shigeki

    Kyobu geka. The Japanese journal of thoracic surgery

    2023  Volume 76, Issue 11, Page(s) 989–992

    Abstract: A 28-year-old right-handed woman had been diagnosed with a tumor of 30 mm in a diameter at the right first intercostal space adjacent to brachial nerve plexus. It was incidentally detected by medical checkup examination five years ago. Because the tumor ... ...

    Abstract A 28-year-old right-handed woman had been diagnosed with a tumor of 30 mm in a diameter at the right first intercostal space adjacent to brachial nerve plexus. It was incidentally detected by medical checkup examination five years ago. Because the tumor enlarged to 36 mm in five years without any symptoms, thoracoscopic tumor resection was planned for diagnosis. Intraoperative neurophysiological monitoring (IONM) was performed to prevent brachial plexus nerve injury. The tumor was totally removed via thoracoscopic approach without postoperative neurological deficit. Histopathological diagnosis was schwannoma. In order to reduce the risk of neural injury, IONM is useful in thoracoscopic removal of the peripheral nerve tumor.
    MeSH term(s) Female ; Humans ; Adult ; Intraoperative Neurophysiological Monitoring ; Neurilemmoma/diagnostic imaging ; Neurilemmoma/surgery ; Brachial Plexus/pathology
    Language Japanese
    Publishing date 2023-12-06
    Publishing country Japan
    Document type Case Reports ; English Abstract ; Journal Article
    ZDB-ID 603899-2
    ISSN 0021-5252
    ISSN 0021-5252
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  6. Article ; Online: Self-assembling peptide gel application to achieve endoscopic hemostasis for fistula bleeding after lumen apposing metal stent removal.

    Nakahara, Kazunari / Sekine, Akihiro / Tateishi, Keisuke

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society

    2023  Volume 35, Issue 3, Page(s) e48–e49

    MeSH term(s) Humans ; Hemostasis, Endoscopic ; Stents ; Endosonography ; Fistula
    Language English
    Publishing date 2023-02-01
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1171589-3
    ISSN 1443-1661 ; 0915-5635
    ISSN (online) 1443-1661
    ISSN 0915-5635
    DOI 10.1111/den.14509
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  7. Article ; Online: Performance of a large language model on Japanese emergency medicine board certification examinations.

    Igarashi, Yutaka / Nakahara, Kyoichi / Norii, Tatsuya / Miyake, Nodoka / Tagami, Takashi / Yokobori, Shoji

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi

    2024  

    Abstract: Background Emergency physicians need a broad range of knowledge and skills to address critical medical, traumatic, and environmental conditions. Artificial intelligence (AI), including large language models (LLMs), has potential applications in ... ...

    Abstract Background Emergency physicians need a broad range of knowledge and skills to address critical medical, traumatic, and environmental conditions. Artificial intelligence (AI), including large language models (LLMs), has potential applications in healthcare settings; however, the performance of LLMs in emergency medicine remains unclear.Methods To evaluate the reliability of information provided by ChatGPT, an LLM was given the questions set by the Japanese Association of Acute Medicine in its board certification examinations over a period of 5 years (2018-2022) and programmed to answer them twice. Statistical analysis was used to assess agreement of the two responses.Results The LLM successfully answered 465 of the 475 text-based questions, achieving an overall correct response rate of 62.3%. For questions without images, the rate of correct answers was 65.9%. For questions with images that were not explained to the LLM, the rate of correct answers was only 52.0%. The annual rates of correct answers to questions without images ranged from 56.3% to 78.8%. Accuracy was better for scenario-based questions (69.1%) than for stand-alone questions (62.1%). Agreement between the two responses was substantial (kappa = 0.70). Factual error accounted for 82% of the incorrectly answered questions.Conclusion An LLM performed satisfactorily on an emergency medicine board certification examination in Japanese and without images. However, factual errors in the responses highlight the need for physician oversight when using LLMs.
    Language English
    Publishing date 2024-03-02
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 2091563-9
    ISSN 1347-3409 ; 1345-4676
    ISSN (online) 1347-3409
    ISSN 1345-4676
    DOI 10.1272/jnms.JNMS.2024_91-205
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  8. Article ; Online: Gut microbiota of Parkinson's disease in an appendectomy cohort: a preliminary study.

    Nakahara, Keiichi / Nakane, Shunya / Ishii, Kazuo / Ikeda, Tokunori / Ando, Yukio

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 2210

    Abstract: In patients with Parkinson's disease (PD), α-synuclein pathology is thought to spread to the brain via the dorsal motor nucleus of the vagus nerve. The link between the gut microbiome and PD has been explored in various studies. The appendix might play ... ...

    Abstract In patients with Parkinson's disease (PD), α-synuclein pathology is thought to spread to the brain via the dorsal motor nucleus of the vagus nerve. The link between the gut microbiome and PD has been explored in various studies. The appendix might play an important role in immunity by maintaining the microbiota as a reservoir. In recent times, appendectomy has been linked to a lower risk of PD, possibly owing to the role of the appendix in altering the gut microbiome. We aimed to elucidate whether the gut microbiota affects PD development in the appendectomy cohort. We analyzed the fecal microbial composition in patients with PD and healthy controls with and without a history of appendectomy. The abundance of microbes from the family Enterobacteriaceae was higher in feces samples from patients with Parkinson's disease compared to that in samples collected from healthy controls. Furthermore, there was a significant phylogenetic difference between patients with PD and healthy controls who had undergone appendectomy. There was a significant phylogenetic difference between patients with PD and HCs who had undergone APP. These results suggest the correlation between gut microbiota and PD in patients who have undergone APP.
    MeSH term(s) Humans ; Parkinson Disease/pathology ; Gastrointestinal Microbiome/physiology ; Appendectomy ; Phylogeny ; Feces
    Language English
    Publishing date 2023-02-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-29219-2
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  9. Article ; Online: IgD lambda multiple myeloma causing hyperammonaemia with possibly reduced ammonium excretion.

    Isse, Naohi / Nakahara, Kei / Sasai, Ryutaro

    BMJ case reports

    2022  Volume 15, Issue 7

    Abstract: A man in his 70s presented with impaired consciousness due to hyperammonaemia while investigating multiple tumours in his brain, chest, spine and right adrenal gland. He did not have any disorders causing hyperammonaemia, such as liver dysfunction, urea- ... ...

    Abstract A man in his 70s presented with impaired consciousness due to hyperammonaemia while investigating multiple tumours in his brain, chest, spine and right adrenal gland. He did not have any disorders causing hyperammonaemia, such as liver dysfunction, urea-producing bacterial infection or any medications interfering with ammonium metabolism. Blood and urine tests in addition to tumour biopsy specimens confirmed immunoglobulin D lambda multiple myeloma. His general status responded to chemotherapy using bortezomib, dexamethasone and daratumumab, and he subsequently regained full consciousness and a normalised serum ammonia level. He, unfortunately, died of refractory multiple myeloma with hyperammonaemia. The autopsy specimen revealed lambda light-chain deposits in the distal tubule epithelium with cast precipitation and intact liver cells. Urine osmolality gap analysis suggested possibly reduced urinary ammonium excretion, but further investigation is necessary to elucidate the significance of pathological renal characteristics in multiple myeloma with hyperammonaemia.
    MeSH term(s) Ammonium Compounds/therapeutic use ; Bortezomib/therapeutic use ; Humans ; Hyperammonemia/drug therapy ; Hyperammonemia/etiology ; Immunoglobulin D ; Male ; Multiple Myeloma/complications ; Multiple Myeloma/drug therapy
    Chemical Substances Ammonium Compounds ; Immunoglobulin D ; Bortezomib (69G8BD63PP)
    Language English
    Publishing date 2022-07-20
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2021-248245
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  10. Article ; Online: Posterior Superior Pancreaticoduodenal Artery Pseudoaneurysm Caused by a Large-bore Biliary Metal Stent.

    Nakahara, Kazunari / Sato, Junya / Tateishi, Keisuke

    Journal of gastrointestinal and liver diseases : JGLD

    2022  Volume 31, Issue 4, Page(s) 382

    MeSH term(s) Humans ; Aneurysm, False/etiology ; Pancreas/blood supply ; Hepatic Artery ; Biliary Tract ; Stents/adverse effects
    Language English
    Publishing date 2022-12-16
    Publishing country Romania
    Document type Journal Article
    ZDB-ID 2427021-0
    ISSN 1842-1121 ; 1841-8724
    ISSN (online) 1842-1121
    ISSN 1841-8724
    DOI 10.15403/jgld-4580
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