2022/12/01 更新

写真a

ナカハラ アサ
中原 亜紗
NAKAHARA Asa
所属
脳研究所 助教
職名
助教
外部リンク

学位

  • 博士(医学) ( 2019年3月   新潟大学 )

経歴(researchmap)

  • 新潟大学   脳研究所 病態神経科学部門 病理学分野   助教

    2022年4月 - 現在

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    国名:日本国

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  • 新潟市民病院   病理診断科   医師

    2019年4月 - 2022年3月

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    国名:日本国

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  • 信州大学   医学部附属病院 卒後臨床研修センター   研修医

    2014年4月 - 2016年3月

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    国名:日本国

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経歴

  • 新潟大学   脳研究所   助教

    2022年4月 - 現在

学歴

  • 新潟大学大学院   医歯学総合研究科博士課程   生体機能調節医学専攻脳病態病理学

    2016年4月 - 2019年3月

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    国名: 日本国

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  • 信州大学大学院   医学系研究科博士課程神経難病学教室

    2014年4月 - 2016年3月

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    国名: 日本国

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  • 信州大学   医学部   医学科

    2008年4月 - 2014年3月

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    国名: 日本国

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論文

  • A 40-year-old man with a rapidly growing intrascrotal tumor in the fibroma-thecoma group. 国際誌

    Tsutomu Anraku, Hideki Hashidate, Asa Nakahara, Tomoyuki Imai, Yoshiaki Kawakami

    IJU case reports   5 ( 3 )   175 - 178   2022年5月

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    記述言語:英語  

    Introduction: Tumors in the fibroma-thecoma group are benign tumors, typically found in the ovaries of postmenopausal women and occasionally develop in the testes. These tumors are mostly treated with radical orchiectomy because preoperative diagnosis confirming the benign nature is difficult. Case presentation: A 40-year-old man was incidentally pointed out to have a right intrascrotal mass, measuring approximately 10 cm on computed tomography. Malignant testicular tumor was suspected based on the location and size of the tumor. The patient underwent right radical orchiectomy. Histologically, the tumor had no evidence of malignancy, and the diagnosis of tumors in the fibroma-thecoma group was made. The patient had no recurrence 8 months after surgery. Conclusion: Intrascrotal tumors in the fibroma-thecoma group are rare benign tumors and mostly treated with radical orchiectomy due to concerns about malignancies. Further investigation is needed for accurate preoperative diagnosis, and we should be aware of these rare tumors.

    DOI: 10.1002/iju5.12430

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  • [Case of Ductal Carcinoma In Situ of the Nipple in a 93-Year-Old Man].

    Yousuke Gohda, Eiko Sakata, Junko Tsuchida, Asa Nakahara, Hideki Hashidate, Hiroyuki Shibuya, Rei Ogawa, Takeshi Higuchi

    Gan to kagaku ryoho. Cancer & chemotherapy   47 ( 13 )   2391 - 2393   2020年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report the case of an elderly male patient with ductal carcinoma in situ(DCIS) of the nipple. A 93-year-old man visited the hospital because of pain and bleeding in and swelling of the right nipple. A benign tumor was suspected, but a definite diagnosis could not be made before surgery based on echo and cytology findings; thus, a malignant tumor could not be ruled out. He underwent partial mastectomy combined with the areola and nipple for diagnosis and treatment. Histologic examination confirmed the diagnosis of DCIS of the nipple. The surgical margin was negative. At 6 months after the surgery, he was doing well with no evidence of disease in the absence of postoperative adjuvant therapy. Thus, clinicians should consider breast carcinoma of the nipple as a differential diagnosis when an elderly man presents with swelling of the nipple.

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  • Malignant adenomyoepithelioma of the breast. 国際誌

    Kazuki Moro, Eiko Sakata, Asa Nakahara, Hideki Hashidate, Emmanuel Gabriel, Haruhiko Makino

    Surgical case reports   6 ( 1 )   118 - 118   2020年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Adenomyoepithelioma (AME) of the breast is a very rare tumor and is generally considered to be benign. However, some show malignant transformation, which results in local recurrences or distant metastases. The morphological features of AME that might predict malignant potential have not been elucidated. Moreover, there is also no established multidisciplinary treatment for malignant AME aside from complete excision at an early stage. CASE PRESENTATION: A 64-year-old female diagnosed with AME of the left breast underwent lumpectomy. The surgical margins were negative. Six months after the operation, however, malignant AME recurred locally in the left breast. MRI showed multiple masses, which invaded the skin. A left mastectomy with axillary lymph node dissection was performed. Additional areas of AME were found in about one third of the entire breast. Eight months after the mastectomy, lung metastases were detected. She underwent chemotherapy with fluorouracil, epirubicin, and cyclophosphamide (FEC) for 9 cycles with little response. Lung metastasectomy was performed. Nine months after lung metastasectomy, the metastases were widespread to the brain, heart, and kidney; she subsequently died 2 months later. CONCLUSIONS: Malignant AME has various morphological features, and in this report, we characterize new findings from both imaging and pathology/autopsy. Malignant potency is related to the tumor size, tumor appearance, and mitoses, even if only a few. Given that ductal spread is one of the morphological features of malignant AME, it is of paramount importance to assess the surgical margins.

    DOI: 10.1186/s40792-020-00881-2

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  • Adult onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) and Nasu-Hakola disease: lesion staging and dynamic changes of axons and microglial subsets. 国際誌

    Kiyomitsu Oyanagi, Michiaki Kinoshita, Emi Suzuki-Kouyama, Teruhiko Inoue, Asa Nakahara, Mika Tokiwai, Nobutaka Arai, Jun-Ichi Satoh, Naoya Aoki, Kenji Jinnai, Ikuru Yazawa, Kimihito Arai, Kenji Ishihara, Mitsuru Kawamura, Keisuke Ishizawa, Kazuko Hasegawa, Saburo Yagisita, Naoji Amano, Kunihiro Yoshida, Seishi Terada, Mari Yoshida, Haruhiko Akiyama, Yoshio Mitsuyama, Shu-Ichi Ikeda

    Brain pathology (Zurich, Switzerland)   27 ( 6 )   748 - 769   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The brains of 10 Japanese patients with adult onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) encompassing hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS) and pigmentary orthochromatic leukodystrophy (POLD) and eight Japanese patients with Nasu-Hakola disease (N-HD) and five age-matched Japanese controls were examined neuropathologically with special reference to lesion staging and dynamic changes of microglial subsets. In both diseases, the pathognomonic neuropathological features included spherically swollen axons (spheroids and globules), axon loss and changes of microglia in the white matter. In ALSP, four lesion stages based on the degree of axon loss were discernible: Stage I, patchy axon loss in the cerebral white matter without atrophy; Stage II, large patchy areas of axon loss with slight atrophy of the cerebral white matter and slight dilatation of the lateral ventricles; Stage III, extensive axon loss in the cerebral white matter and dilatation of the lateral and third ventricles without remarkable axon loss in the brainstem and cerebellum; Stage IV, devastated cerebral white matter with marked dilatation of the ventricles and axon loss in the brainstem and/or cerebellum. Internal capsule and pontine base were relatively well preserved in the N-HD, even at Stage IV, and the swollen axons were larger with a higher density in the ALSP. Microglial cells immunopositive for CD68, CD163 or CD204 were far more obvious in ALSP, than in N-HD, and the shape and density of the cells changed in each stage. With progression of the stage, clinical symptoms became worse to apathetic state, and epilepsy was frequently observed in patients at Stages III and IV in both diseases. From these findings, it is concluded that (i) shape, density and subsets of microglia change dynamically along the passage of stages and (ii) increase of IBA-1-, CD68-, CD163- and CD204-immunopositive cells precedes loss of axons in ALSP.

    DOI: 10.1111/bpa.12443

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  • Axonal TDP-43 aggregates in sporadic amyotrophic lateral sclerosis. 国際誌

    T Onozato, A Nakahara, E Suzuki-Kouyama, A Hineno, T Yasude, T Nakamura, H Yahikozawa, M Watanabe, K Kayanuma, H Makishita, S Ohara, T Hashimoto, K Higuchi, T Sakai, K Asano, T Hashimoto, H Kanno, J Nakayama, K Oyanagi

    Neuropathology and applied neurobiology   42 ( 6 )   561 - 72   2016年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIMS: Axonal aggregates of phosphorylated (p-) transactive response DNA-binding protein 43 kDa (TDP-43) in sporadic amyotrophic lateral sclerosis (sALS) were examined in relation to propagation of the protein in the nervous system. METHODS: Brains and spinal cords of Japanese patients with sALS and control subjects were examined immunohistochemically using formalin-fixed paraffin-embedded specimens with special reference to the topographical distribution, microscopic features, presynaptic aggregates, and correlation between the aggregates in axons and the clinical course. RESULTS: (i) Aggregates of p-TDP-43 were frequently present in axons of the hypoglossal and facial nerve fibres and the spinal anterior horn cells. (ii) Aggregates of p-TDP-43 in the axons showed two characteristic microscopic features - dash-like granuloreticular aggregates (GRAs) and massive aggregates (MAs). (iii) MAs were surrounded by p-neurofilaments, but p-neurofilament immunnoreactivity decreased at the inside of axons with GRAs. (iv) Patients showing MAs and GRAs had a relatively shorter clinical course than patients without the aggregates. (v) Some neurones in the red nucleus in patients were surrounded by synapses containing p- and p-independent (i)-TDP-43, and almost all neurones had lost their nuclear TDP-43 immunoreactivity; 17% of those neurones in the red nucleus also had TDP-43-immunopositive neuronal cytoplasmic inclusions, but no postsynaptic p-TDP-43 deposition was evident. CONCLUSIONS: There are two types of axonal p-TDP-43 aggregates, MAs and GRAs, located predominantly in the facial and hypoglossal nuclei and anterior horn cells. These aggregates may influence the function of neurones, and presynaptic aggregates of the protein induce loss of p-i-TDP-43 in the nuclei of postsynaptic neurones.

    DOI: 10.1111/nan.12310

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  • Crossed Cerebellar Diaschisis in Status Epilepticus.

    Daigo Miyazaki, Kazuhiro Fukushima, Asa Nakahara, Minori Kodaira, Katsunori Mochizuki, Kikuko Kaneko, Tomoki Kaneko, Yoshiki Sekijima, Shu-Ichi Ikeda

    Internal medicine (Tokyo, Japan)   55 ( 12 )   1649 - 51   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Crossed cerebellar diaschisis (CCD) is an interesting phenomenon which classically refers to the depressed blood flow and metabolism affecting one cerebellar hemisphere after a contralateral hemispheric infarction. However, CCD can also be caused by a prolonged seizure. We herein report a case of CCD due to status epilepticus in a patient who showed unique magnetic resonance imaging findings.

    DOI: 10.2169/internalmedicine.55.6689

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  • "Gliomatosis encephali" as a novel category of brain tumors by the first autopsy case report of gliomatosis cerebelli. 国際誌

    Asa Nakahara, Toshikazu Yoshida, Masanobu Yazawa, Takashi Ehara, Jun Nakayama, Akiyoshi Kakita, Ryosuke Ogura, Mika Asakawa, Emi Suzuki-Kouyama, Kiyomitsu Oyanagi

    Neuropathology : official journal of the Japanese Society of Neuropathology   34 ( 3 )   295 - 303   2014年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Gliomatosis cerebri is a rare diffuse glioma that is neither mass-forming nor necrotic, and does not disrupt existing structures. Gliomatosis occurring in the cerebellum is known as gliomatosis cerebelli, and only three such cases examined by biopsy have been reported. Here we describe the first autopsy findings of a patient who was diagnosed as having gliomatosis in the cerebellum. Neuropathological examination identified the tumor cells as being positive for glial fibrillary acidic protein, vimentin and nestin, with atypical nuclei that were cashew-nut- or dishcloth-gourd-shaped. These tumor cells were dense in the right cerebellum, but also spread broadly throughout the brain including the left cerebrum and optic nerve. Mitotic figures were frequently seen in the cerebellum, brain stem and cerebrum. Scherer's secondary structures were evident not only in the cerebellum but also the cerebrum. No necrosis, microvascular proliferation or destruction of anatomical structures was detected in the whole brain. Differences in the origin of the tumors of the gliomatoses cerbri and cerebelli suggests these tumors are different types of brain tumors. Thus the findings support that the gliomatosis cerebelli is a novel type of brain tumor classification. Furthermore, by the similarities of the histological features among the tumors, it appears appropriate to establish a novel category of "gliomatosis encephali" which includes both gliomatosis cerebri and gliomatosis cerebelli.

    DOI: 10.1111/neup.12083

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