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Watase M, Miyata J, Terai H, Sunata K, Matsuyama E, Asakura T, Namkoong H, Masaki K, Yagi K, Ohgino K, Chubachi S, Kawada I, Mochimaru T, Satomi R, Oyamada Y, Kobayashi K, Hirano T, Inoue T, Lee H, Sugihara K, Omori N, Sayama K, Mashimo S, Makino Y, Kaido T, Ishii M, Fukunaga K. Cough and sputum in long COVID are associated with severe acute COVID-19: a Japanese cohort study. Respir Res 2023; 24:283. [PMID: 37964338 PMCID: PMC10648313 DOI: 10.1186/s12931-023-02591-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Multiple prolonged symptoms are observed in patients who recover from acute coronavirus disease 2019 (COVID-19), defined as long COVID. Cough and sputum are presented by patients with long COVID during the acute and post-acute phases. This study aimed to identify specific risk factors for cough and sputum in patients with long COVID. METHODS Hospitalized patients with COVID-19 aged 18 years were enrolled in a multicenter cohort study at 26 medical institutions. Clinical data during hospitalization and patient-reported outcomes after discharge were collected from medical records, paper-based questionnaires, and smartphone apps. RESULTS At the 3-, 6-, and 12-month follow-ups, there were no differences in the incidence rates of wet and dry coughs. In contrast, the proportion of patients presenting sputum without coughing increased over time compared to those with sputum and coughing. Univariate analyses of cough and sputum at all follow-up visits identified intermittent mandatory ventilation (IMV), smoking, and older age as risk factors for prolonged symptoms. At the 12-month follow-up, persistent cough and sputum were associated with the characteristics of severe COVID-19 based on imaging findings, renal and liver dysfunction, pulmonary thromboembolism, and higher serum levels of LDH, KL-6, and HbA1C. The Kaplan-Meier curves showed that the severity of acute COVID-19 infection was correlated with prolonged cough and sputum production. Multivariable logistic regression analysis showed that IMV ventilator management were independent risk factors for prolonged cough and sputum at 12 months. CONCLUSIONS In a Japanese population with long COVID, prolonged cough and sputum production were closely associated with severe COVID-19. These findings emphasize that a preventive approach including appropriate vaccination and contact precaution and further development of therapeutic drugs for COVID-19 are highly recommended for patients with risk factors for severe infection to avoid persistent respiratory symptoms.
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Affiliation(s)
- Mayuko Watase
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Jun Miyata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Keio Cancer Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Tokyo, Japan.
| | - Keeya Sunata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Emiko Matsuyama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takanori Asakura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuma Yagi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keiko Ohgino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Keio University Health Center, Tokyo, Japan
| | - Takao Mochimaru
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Ryosuke Satomi
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yoshitaka Oyamada
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Keigo Kobayashi
- Department of Internal Medicine, Sano Kosei General Hospital, Tochigi, Japan
| | - Toshiyuki Hirano
- Department of Internal Medicine, Sano Kosei General Hospital, Tochigi, Japan
| | - Takashi Inoue
- Department of Internal Medicine, Sano Kosei General Hospital, Tochigi, Japan
| | - Ho Lee
- Department of Pulmonary Medicine, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Kai Sugihara
- Department of Pulmonary Medicine, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Nao Omori
- Department of Pulmonary Medicine, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Koichi Sayama
- Department of Pulmonary Medicine, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Shuko Mashimo
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Yasushi Makino
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Tatsuya Kaido
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Makoto Ishii
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Terai H, Ishii M, Takemura R, Namkoong H, Shimamoto K, Masaki K, Tanosaki T, Chubachi S, Matsuyama E, Hayashi R, Shimada T, Shigematsu L, Ito F, Kaji M, Takaoka H, Kurihara M, Nakagawara K, Tomiyasu S, Sasahara K, Saito A, Otake S, Azekawa S, Okada M, Fukushima T, Morita A, Tanaka H, Sunata K, Asaoka M, Nishie M, Shinozaki T, Ebisudani T, Akiyama Y, Mitsuishi A, Nakayama S, Ogawa T, Sakurai K, Irie M, Yagi K, Ohgino K, Miyata J, Kabata H, Ikemura S, Kamata H, Yasuda H, Kawada I, Kimura R, Kondo M, Iwasaki T, Ishida N, Hiruma G, Miyazaki N, Ishibashi Y, Harada S, Fujita T, Ito D, Bun S, Tabuchi H, Kanzaki S, Shimizu E, Fukuda K, Yamagami J, Kobayashi K, Hirano T, Inoue T, Haraguchi M, Kagyo J, Shiomi T, Lee H, Sugihara K, Omori N, Sayama K, Otsuka K, Miyao N, Odani T, Watase M, Mochimaru T, Satomi R, Oyamada Y, Masuzawa K, Asakura T, Nakayama S, Suzuki Y, Baba R, Okamori S, Arai D, Nakachi I, Kuwahara N, Fujiwara A, Oakada T, Ishiguro T, Isosno T, Makino Y, Mashimo S, Kaido T, Minematsu N, Ueda S, Minami K, Hagiwara R, Manabe T, Fukui T, Funatsu Y, Koh H, Yoshiyama T, Kokuto H, Kusumoto T, Oashi A, Miyawaki M, Saito F, Tani T, Ishioka K, Takahashi S, Nakamura M, Harada N, Sasano H, Goto A, Kusaka Y, Ohba T, Nakano Y, Nishio K, Nakajima Y, Suzuki S, Yoshida S, Tateno H, Kodama N, Shunsuke M, Sakamoto S, Okamoto M, Nagasaki Y, Umeda A, Miyagawa K, Shimada H, Hagimura K, Nagashima K, Sato T, Sato Y, Hasegawa N, Takebayashi T, Nakahara J, Mimura M, Ogawa K, Shimmura S, Negishi K, Tsubota K, Amagai M, Goto R, Ibuka Y, Kitagawa Y, Kanai T, Fukunaga K. Comprehensive analysis of long COVID in a Japanese nationwide prospective cohort study. Respir Investig 2023; 61:802-814. [PMID: 37783167 DOI: 10.1016/j.resinv.2023.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/15/2023] [Accepted: 08/16/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly since 2019, and the number of reports regarding long COVID has increased. Although the distribution of long COVID depends on patient characteristics, epidemiological data on Japanese patients are limited. Hence, this study aimed to investigate the distribution of long COVID in Japanese patients. This study is the first nationwide Japanese prospective cohort study on long COVID. METHODS This multicenter, prospective cohort study enrolled hospitalized COVID-19 patients aged ≥18 years at 26 Japanese medical institutions. In total, 1200 patients were enrolled. Clinical information and patient-reported outcomes were collected from medical records, paper questionnaires, and smartphone applications. RESULTS We collected data from 1066 cases with both medical records and patient-reported outcomes. The proportion of patients with at least one symptom decreased chronologically from 93.9% (947/1009) during hospitalization to 46.3% (433/935), 40.5% (350/865), and 33.0% (239/724) at 3, 6, and 12 months, respectively. Patients with at least one long COVID symptom showed lower quality of life and scored higher on assessments for depression, anxiety, and fear of COVID-19. Female sex, middle age (41-64 years), oxygen requirement, and critical condition during hospitalization were risk factors for long COVID. CONCLUSIONS This study elucidated the symptom distribution and risks of long COVID in the Japanese population. This study provides reference data for future studies of long COVID in Japan.
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Affiliation(s)
- Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Keio Cancer Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Makoto Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Furocho, Chikusa Ward, Nagoya, Aichi, 466-8550, Japan
| | - Ryo Takemura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ho Namkoong
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kyoko Shimamoto
- Keio Global Research Institute, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takae Tanosaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Emiko Matsuyama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Reina Hayashi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takashi Shimada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Lisa Shigematsu
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Fumimaro Ito
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masanori Kaji
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hatsuyo Takaoka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Momoko Kurihara
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kensuke Nakagawara
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Saki Tomiyasu
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kotaro Sasahara
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ayaka Saito
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shiro Otake
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shuhei Azekawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masahiko Okada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takahiro Fukushima
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Atsuho Morita
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiromu Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keeya Sunata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masato Asaoka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Miyuki Nishie
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Taro Shinozaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toshiki Ebisudani
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuto Akiyama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Akifumi Mitsuishi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shingo Nakayama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takunori Ogawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kaori Sakurai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Misato Irie
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuma Yagi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keiko Ohgino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Jun Miyata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiroki Kabata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shinnosuke Ikemura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hirofumi Kamata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryusei Kimura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masahiro Kondo
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toshiki Iwasaki
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Noriyuki Ishida
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Gaku Hiruma
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naoki Miyazaki
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yoshiki Ishibashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Sei Harada
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takanori Fujita
- Department of Health Policy and Management, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Daisuke Ito
- Department of Physiology/Memory Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shogyoku Bun
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Sho Kanzaki
- Department of Otolaryngology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Eisuke Shimizu
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keitaro Fukuda
- Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Jun Yamagami
- Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keigo Kobayashi
- Department of Internal Medicine, Sano Kosei General Hospital, 1728 Horigomecho, Sano, Tochigi, 327-8511, Japan
| | - Toshiyuki Hirano
- Department of Internal Medicine, Sano Kosei General Hospital, 1728 Horigomecho, Sano, Tochigi, 327-8511, Japan
| | - Takashi Inoue
- Department of Internal Medicine, Sano Kosei General Hospital, 1728 Horigomecho, Sano, Tochigi, 327-8511, Japan
| | - Mizuha Haraguchi
- Department of Internal Medicine, Keiyu Hospital, Kanagawa, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, 220-0012, Japan
| | - Junko Kagyo
- Department of Internal Medicine, Keiyu Hospital, Kanagawa, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, 220-0012, Japan
| | - Tetsuya Shiomi
- Department of Internal Medicine, Keiyu Hospital, Kanagawa, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, 220-0012, Japan
| | - Ho Lee
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Division of Pulmonary Medicine, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0013, Japan
| | - Kai Sugihara
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0013, Japan
| | - Nao Omori
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0013, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0013, Japan
| | - Kengo Otsuka
- Department of Internal Medicine, Nihon Koukan Hospital, 1-2-1 Kokandori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0852, Japan
| | - Naoki Miyao
- Department of Internal Medicine, Nihon Koukan Hospital, 1-2-1 Kokandori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0852, Japan
| | - Toshio Odani
- Department of Rheumatology, National Hospital Organization Hokkaido Medical Center, 7-1-1 Yamanote 5 Jo, Nishi-ku, Sapporo, Hokkaido, 063-0005, Japan
| | - Mayuko Watase
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Respiratory Medicine, National Hospital Organisation Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Takao Mochimaru
- Department of Respiratory Medicine, National Hospital Organisation Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Ryosuke Satomi
- Department of Respiratory Medicine, National Hospital Organisation Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Yoshitaka Oyamada
- Department of Respiratory Medicine, National Hospital Organisation Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Keita Masuzawa
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8642, Japan
| | - Takanori Asakura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8642, Japan
| | - Sohei Nakayama
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8642, Japan
| | - Yusuke Suzuki
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8642, Japan
| | - Rie Baba
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya, Tochigi, 321-0974, Japan
| | - Satoshi Okamori
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya, Tochigi, 321-0974, Japan
| | - Daisuke Arai
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya, Tochigi, 321-0974, Japan
| | - Ichiro Nakachi
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya, Tochigi, 321-0974, Japan
| | - Naota Kuwahara
- Department of Medicine, Division of Allergology and Respiratory Medicine, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, 135-8577, Japan
| | - Akiko Fujiwara
- Department of Medicine, Division of Allergology and Respiratory Medicine, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, 135-8577, Japan
| | - Takenori Oakada
- Department of Medicine, Division of Allergology and Respiratory Medicine, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, 135-8577, Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0197, Japan
| | - Taisuke Isosno
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0197, Japan
| | - Yasushi Makino
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, 50 Hachikennishi, Aotakecho, Toyohashi, Aichi, 441-8570, Japan
| | - Shuko Mashimo
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, 50 Hachikennishi, Aotakecho, Toyohashi, Aichi, 441-8570, Japan
| | - Tatsuya Kaido
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, 50 Hachikennishi, Aotakecho, Toyohashi, Aichi, 441-8570, Japan
| | - Naoto Minematsu
- Department of Internal Medicine, Hino Municipal Hospital, 4-3-1, Tamadaira, Hino-city, Tokyo, 191-0062, Japan
| | - Soichiro Ueda
- Department of Internal Medicine, Saitama Medical Center, 1981 Kamoda, Kawagoeshi, Saitama, 350-8550, Japan
| | - Kazuhiro Minami
- Department of Internal Medicine, Saitama Medical Center, 1981 Kamoda, Kawagoeshi, Saitama, 350-8550, Japan
| | - Rie Hagiwara
- Department of Internal Medicine, Saitama Medical Center, 1981 Kamoda, Kawagoeshi, Saitama, 350-8550, Japan
| | - Tadashi Manabe
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, 4-2-22 Nishikicho, Tachikawa, Tokyo, 190-8531, Japan
| | - Takahiro Fukui
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, 4-2-22 Nishikicho, Tachikawa, Tokyo, 190-8531, Japan
| | - Yohei Funatsu
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, 4-2-22 Nishikicho, Tachikawa, Tokyo, 190-8531, Japan
| | - Hidefumi Koh
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, 4-2-22 Nishikicho, Tachikawa, Tokyo, 190-8531, Japan
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Hiroyuki Kokuto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Tatsuya Kusumoto
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo, 110-8645, Japan
| | - Ayano Oashi
- Department of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo, 110-8645, Japan
| | - Masayoshi Miyawaki
- Department of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo, 110-8645, Japan
| | - Fumitake Saito
- Department of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo, 110-8645, Japan
| | - Tetsuo Tani
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073, Japan
| | - Kota Ishioka
- Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073, Japan
| | - Saeko Takahashi
- Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073, Japan
| | - Morio Nakamura
- Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073, Japan
| | - Norihiro Harada
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hitoshi Sasano
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ai Goto
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yu Kusaka
- Department of Respiratory Medicine, Ome Municipal General Hospital, 4-16-5, Higashiome, Ome, Tokyo, 198-0042, Japan
| | - Takehiko Ohba
- Department of Respiratory Medicine, Ome Municipal General Hospital, 4-16-5, Higashiome, Ome, Tokyo, 198-0042, Japan
| | - Yasushi Nakano
- Department of Pulmonary Medicine, Kawasaki Municipal Ida Hospital, 2-27-1 Ida, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-0035, Japan
| | - Kazumi Nishio
- Department of Pulmonary Medicine, Kawasaki Municipal Ida Hospital, 2-27-1 Ida, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-0035, Japan
| | - Yukiko Nakajima
- Department of Infectious Disease, Kawasaki Municipal Ida Hospital, 2-27-1 Ida, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-0035, Japan
| | - Shoji Suzuki
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Shuichi Yoshida
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Hiroki Tateno
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Nobuhiro Kodama
- Department of General Internal Medicine, Fukuoka Tokushukai Hospital, 4-5 Sugukita, Kasuga, Fukuoka, 816-0864, Japan
| | - Maeda Shunsuke
- Department of General Internal Medicine, Fukuoka Tokushukai Hospital, 4-5 Sugukita, Kasuga, Fukuoka, 816-0864, Japan
| | - Satoshi Sakamoto
- Department of Internal Medicine, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Masaki Okamoto
- Department of Internal Medicine, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan; Department of Respirology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan
| | - Yoji Nagasaki
- Department of Infectious Disease and Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan
| | - Akira Umeda
- Department of Respiratory Medicine, International University of Health and Welfare Shioya Hospital, 2600-1 Kitakanemaru, Otawara, Tochigi, 324-8501, Japan
| | - Kazuya Miyagawa
- Department of Pharmacology, School of Pharmacy, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi, 324-8501, Japan
| | - Hisato Shimada
- Department of Pharmacology, School of Pharmacy, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi, 324-8501, Japan
| | - Kazuto Hagimura
- Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toshiro Sato
- Department of Organoid Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yasunori Sato
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kaoru Ogawa
- Department of Otolaryngology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shigeto Shimmura
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Rei Goto
- Graduate School of Business Administration, Keio University, 4-1-1 Hiyoshi Kohoku-ku, Yokohama, Kanagawa, 223-8526, Japan
| | - Yoko Ibuka
- Faculty of Economics, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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3
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Muto Y, Hagiwara E, Baba T, Sato Y, Sakayori M, Tabata E, Sekine A, Komatsu S, Okudela K, Sayama K, Ogura T. Unilateral Autoimmune Pulmonary Alveolar Proteinosis with Polymyositis-related Interstitial Lung Disease. Intern Med 2022; 61:3095-3100. [PMID: 35370233 PMCID: PMC9646339 DOI: 10.2169/internalmedicine.9015-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A 61-year-old patient with cystic bronchiectasis and bronchial artery hyperplasia in the left lung was diagnosed with polymyositis-related interstitial lung disease. After nine months of immunosuppressive therapy, he developed unilateral autoimmune pulmonary alveolar proteinosis (APAP) in the right lung with respiratory failure. After bronchial artery embolization to prevent massive hemoptysis, whole-lung lavage was performed using veno-venous extracorporeal membrane oxygenation. His respiratory condition improved, and he was discharged from the hospital with supplemental oxygen. Three reported cases of APAP with polymyositis-related interstitial lung disease, including the present case, were all positive for anti-glycyl tRNA synthetase antibody and were under immunosuppressive treatment.
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Affiliation(s)
- Yutaka Muto
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Tomohisa Baba
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Yozo Sato
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Masashi Sakayori
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Erina Tabata
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Akimasa Sekine
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Shigeru Komatsu
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Koji Okudela
- Department of Pathology, Yokohama City University School of Medicine, Japan
| | - Koichi Sayama
- Department of Respiratory Medicine, Kawasaki Municipal Hospital, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
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4
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Hada M, Hoshino M, Sugiyama T, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. the diagnostic value of left-anterior-descending artery velocity assessed by transthoracic Doppler echocardiography for microvascular dysfunction in stenotic left-anterior-descending artery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Index of microcirculatory resistance (IMR) has been used as a clinical measure of microvascular function. Transthoracic Doppler echocardiography (TDE) can provide information on the functional status of coronary artery circulation. This study aims to assess the diagnostic value of left-anterior-descending artery (LAD) flow velocity by TDE for microvascular dysfunction.
Methods
Consecutive patients who were scheduled for elective percutaneous coronary intervention (PCI) for LAD lesions were prospectively enrolled in the single tertiary-care center between April 2020 and July 2021. Pre-PCI LAD diastolic peak velocity (DPV) by TDE at rest and hyperemia were measured. By invasive coronary angiography, quantitative coronary angiography and invasive wire-based physiological indices including fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) were measured.
Results
A total of 104 patients were studied. Median FFR and IMR values were 0.70 (0.60–0.74) and 20.68 (14.92–31.69), respectively. No significant relationship was observed between FFR and IMR. The prevalence of microvascular dysfunction defined as IMR≥25 was 39.4%. Basal DPV was 25 (20–33) cm/sec, and hyperemic DPV was 51 (41–67) cm/sec. In lesions with IMR≥25, reference diameter (RD) was significantly greater [2.63 (2.22–3.19) mm vs 2.39 (2.09–2.66) mm, p=0.019], basal DPV was lower [26 (18–29) cm/sec vs 29 (22–37) cm/sec, p=0.022)] and hyperemic DPV was lower [49 (19–54) cm/sec vs 56 (42–70) cm/sec, p=0.023] compared to lesions with IMR<25. ROC analysis showed basal DPV and RD are significant predictors of IMR≥25 [basal DPV: AUC 0.633 (0.525–0.742), best cutoff 29cm/sec RD: AUC 0.636 (0.523–0.750), best cutoff 2.84mm]. Multivariable logistic regression analysis showed basal DPV<29cm/sec and RD>2.84mm are independent predictors for IMR≥25 [Odds ratio: 3.08 (1.22–7.78), p=0.017; odds ratio 4.40 (1.55–12.50), p=0.005].
Conclusion
Basal DPV by non-invasive pre-PCI TDE and reference diameter can predict lesions with coexisting microvascular dysfunction in LAD territory with functionally significant lesions without the need of vasodilator-induced hyperemia and a wire-based invasive physiological measurement.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
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5
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Nogami K, Hoshino M, Kanaji Y, Sugiyama T, Misawa T, Hada M, Yamaguchi M, Nagamine T, Teng Y, Ueno H, Matsuda K, Sayama K, Kakuta T. Prognostic implications of unrecognized myocardial infarction before elective percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A non-negligible proportion of myocardial infarction (MI) is not clinically recognized and unrecognized myocardial infarction (UMI) is associated with adverse outcomes.
Purpose
To determine the prevalence and prognostic significance of UMI by delayed-enhancement cardiac magnetic resonance (DE-CMR) before elective percutaneous coronary intervention (PCI).
Methods
In this prospective, single-center study, 236 patients with stable coronary artery disease undergoing elective and uncomplicated PCI were studied. All patients underwent DE-CMR before PCI. The prevalence of UMI was evaluated and the association of clinical and CMR-derived variables with primary MACE, defined as cardiovascular death, nonfatal MI, hospitalization for heart failure, unplanned late revascularization, and ischemic stroke was investigated.
Results
In the final analysis of 213 patients, 63 patients (29.6%) showed UMI. Target territory UMI was observed in 38 (17.8% of total, 60.3% of patients with UMI). UMI was significantly associated with sex, diabetes mellitus, left ventricular ejection fraction, SYNTAX score and fractional flow reserve in target vessels. During follow-up periods (median, 23 months), MACE was observed in 17 (27.0%) of patients with UMI, and 17 (11.3%) without (P=0.001). In a multivariable model, UMI (hazard ratio [HR] 2.18, 95% confidential interval, 1.10–4.33, P=0.001) remained as an independent predictor of MACE. Kaplan–Meier analysis indicated that the presence of UMI was significantly associated with higher incidence of MACE.
Conclusions
The prevalence of UMI in patients undergoing elective PCI was 29.6%. UMI was independently associated with an increased risk of MACE after successful PCI. Given the non-negligible prevalence and potential clinical significance of UMI, clinical studies comparing PCI and guideline directed medical therapy (GDMT) versus GDMT only strategy might have to take the presence of UMI into consideration.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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6
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Sayama K, Hoshino M, Kanaji Y, Sugiyama T, Misawa T, Hada M, Nagamine T, Nogami K, Teng Y, Ueno H, Matsuda K, Yonetsu T, Kakuta T. Prognostic implication of unrecognized myocardial infarction in patients with non-ST-segment-elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Prognostic value of unrecognized non-infarct-related territory (non-IR) myocardial infarction (UMI) in patients with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) remains to be elucidated.
Purpose
This study sought to evaluate the prevalence of non-IR UMI and its prognostic value in patients with first NSTE-ACS presentation.
Methods
This retrospective single-center analysis was conducted in patients with NSTE-ACS without prior history of coronary artery disease, who underwent uncomplicated urgent percutaneous coronary intervention (PCI) within 48 hours of admission between August 2014 and January 2018. All patients underwent postprocedural cardiac magnetic resonance imaging (CMR) within 30 days after PCI. Non-IR UMI was defined as the presence of non-IR delayed gadolinium enhancement with an ischemic distribution pattern. We investigated the association of non-IR UMI, other CMR findings and baseline clinical characteristics with major adverse cardiac events (MACE), defined as all-cause death, non-fatal myocardial infarction, ischemic stroke, late revascularization and hospitalization for congestive heart failure.
Results
A total of 168 NSTE-ACS patients were included (124 males (73.8%); 66±11 years). Non-IR UMI was detected in 28 patients (16.7%). During a median follow-up of 32 months (15–58), MACE occurred in 10 (35.7%) patients with non-IR UMI, and 20 (14.3%) patients without (P=0.013). Patients with MACE showed higher frequency of non-IR UMI in RCA territory and multi vessel disease, higher level of NT-proBNP at admission, higher Genisini score, and greater extent of UMI. Cox's proportional hazards analysis showed that the presence of non-IR UMI was an independent predictor of MACE (HR 2.34, 95% CI 1.02–5.37, P=0.045), after adjusting confounding factors, such as multi vessel disease and serum levels of NT-proBNP at admission. The discriminant efficacy (IDI and NRI) of predicting MACE was significantly improved when the presence of non-IR UMI added to the reference clinical risk model. Kaplan-Meier analysis revealed that patients with non-IR UMI were significantly associated with poor prognosis. (Figure 1).
Conclusions
In patients with NSTE-ACS undergoing urgent PCI, the prevalence of non-IR UMI was 16.7%. Non-IR UMI provided prognostic information independent of conventional risk factors.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Division of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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7
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Hada M, Hoshino M, Sugiyama T, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Diagnostic value of computed tomography myocardial perfusion to detect coexisting microvascular dysfunction in patients with obstructive epicardial coronary disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The usefulness of computed tomography myocardial perfusion (CTP) to assess hemodynamically significant epicardial coronary artery lesions has been previously reported. However, the diagnostic value of quantitative evaluation of absolute coronary flow by CTP to detect microvascular dysfunction remains unknown.
Purpose
The aim of study is to assess the diagnostic value of CTP to evaluate coronary microvascular dysfunction (CMD) in patients with significant epicardial coronary stenosis, and to analyze the predicting factors for lesions with CMD.
Methods
Sixty-eight chronic coronary syndrome patients with de novo single functionally significant stenosis (Fractional flow reserve [FFR] <0.80) were investigated. CMD was defined by the index of microcirculatory resistance (IMR) ≥25. Clinical characteristics and CTP findings were compared between the two groups with and without CMD (CMD, n=29, non-CMD, n=39, respectively). The computed tomography angiography (CCTA) assessment included CTP findings and quantitative and qualitative assessment of plaques.
Results
In wire-based analysis, FFR, coronary flow reserve (CFRwire) and IMR were 0.68 (0.59–0.74), 1.71 (1.24–2.88), and 22.6 (15.1–34.5), respectively.
In CTP analysis, culprit territory regional absolute myocardial blood flow (MBF) at rest (rest-MBF) and hyperemia (hyperemic-MBF) were evaluated semi-automatically. CTP-derived CFR (CFRCTP) was calculated as hyperemic-MBF divided by rest-MBF. Rest and hyperemic-MBF and CFRCTP were 0.83 (0.64–1.03) ml/min/g, 2.14 (1.30–2.92) ml/min/g, and 2.19 (1.44–3.37).
In the lesions with CMD, hyperemic-MBF was significantly lower than those without CMD (1.68 [0.84–2.44] vs 2.31 [1.67–3.34] ml/min/g, p=0.015) and the prevalence of CFRCTP<2.0 was higher in the lesions with CMD than those without CMD (62.1% vs 28.2%, p=0.007).
CCTA analysis showed that fibrofatty and necrotic core component (FFNC) volume was greater in the lesions with CMD than in the lesions without CMD (31.8 [19.0–48.9] vs 25.1 [17.2–32.1] mm3, p=0.045). The multivariable logistic regression analysis, hyperemic-MBF and FFNC volume were independent predictors for lesions with CMD (Odds ratio [OR] 0.583 [0.355–0.958], p=0.033 and OR 1.040 [1.010–1.070], p=0.018).
Conclusion
Quantitative assessment of absolute coronary flow by CTP and comprehensive plaque analysis by CCTA may help detect coexisting subtended microvascular dysfunction in patients with functionally significant epicardial coronary lesions. Further studies are needed to elucidate the clinical significance of coexisting CMD in CCS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
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8
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Hoshino M, Sugiyama T, Kanaji Y, Hada M, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Multimodality coronary imaging to predict non-culprit territory unrecognized myocardial infarction assessed by cardiac magnetic resonance in non-ST-elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
This study sought to assess the predictors of coherence tomography (OCT) and coronary computed tomography angiographic (CCTA) findings for non-infarct-related (non-IR) territory unrecognized myocardial infarction (UMI) in patients with first non-ST-elevation acute coronary syndrome (NSTE-ACS) presentation.
Background
UMI detected by cardiac magnetic resonance (CMR) is associated with adverse outcomes in patients with both acute coronary syndrome and chronic coronary syndrome. However, the association between the presence of UMI and findings of multimodality coronary imaging remains unknown.
Methods
We investigated 69 patients with a first clinical episode of NSTE-ACS, who underwent pre-PCI 320-slice CCTA, uncomplicated urgent percutaneous coronary intervention (PCI) with OCT assessment within 48 hours of admission, and post-PCI CMR. UMI was assessed on late gadolinium enhancement (LGE-CMR) by identifying regions of hyperenhancement with an ischemic distribution pattern in non-IR territories (non-IR UMI).
Results
Non-IR UMI was detected in 11 patients (15.9%). ROC analysis revealed the optimal cut-off value of PCATA in culprit vessel for predicting the presence of non-IR UMI were −71.3. Lower ejection fraction, higher Gensini score, high pericoronary inflammation (>−71.3), OCT-defined culprit lesion plaque rupture (OCT-PR), and OCT-defined culprit lesion cholesterol crystal (OCT-CC) were significantly associated with the presence of non-IR UMI (Figure 1A). OCT findings are shown in Figure 1B. Patients with non-IR UMI had a higher prevalence of OCT-PR and OCT-CC than those without. Compared with patients without non-IR UMI, the prevalence of high pericoronary inflammation was higher in patients with non-IR UMI (Figure 1C). When the total cohort was divided into four groups according to the numbers of aforementioned OCT-derived risk factors and PCATA, patients with all of these UMI risk factors showed 46.2% (6/13) prevalence of non-IR UMI, whereas none of 15 patients without these factors showed non-IR UMI (Figure 1D).
Conclusions
When culprit lesion showed OCT-PR, OCT-CC, and high PCATA, about half of these patients are likely to have non-IR UMI. The integrated CCTA and OCT assessment may help identify the presence of non-IR UMI, potentially providing prognostic information in first NSTE-ACS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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9
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Ueno H, Hoshino M, Sugiyama T, Kanaji Y, Hada M, Misawa T, Nagamine T, Nogami K, Sayama K, Matsuda K, Yonetsu T, Sasano T, Kakuta T. Prognostic implications of fractional flow reserve and coronary flow reserve after newer-generation drug-eluting stent implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
FFR after percutaneous coronary intervention (PCI) has been reported to provide prognostic information. However, limited data are available regarding the prognostication by CFR in patients treated with elective PCI using newer generation DES.
Purpose
This study aimed to assess the prognostic value of post-procedural fractional flow reserve (FFR) and coronary flow reserve (CFR) after newer-generation drug-eluting stent implantation (DES).
Methods
A total of 466 stenoses in 466 patients underwent FFR-guided PCI. FFR and CFR measurements before and after PCI by a pressure-temperature sensor-tipped wire were performed. Follow-up data were studied to determine the predictors of target vessel failure (TVF), defined as death, target vessel-related nonfatal myocardial infarction, and unplanned clinically driven target vessel late revascularization. Prognostic value of post-PCI CFR was compared with that of FFR or FFR/CFR combination.
Results
After PCI completion, 13.7% showed post-PCI FFR ≤0.80 and 44.2% exhibited post-PCI CFR <2.5. Discordant results were observed in 42.5% (198/466). During 2.7 (1.8–3.3) years follow-up, 57 (12.2%) TVF were documented. The multivariable Cox proportional hazard regression analysis revealed that post-PCI FFR and post-PCI CFR were independent prognostic factors. ROC analysis revealed that the optimal cut-off values of post-PCI FFR and CFR values were 0.85 and 2.26, respectively. Significant differences in TVF were detected according to post-PCI FFR (≤0.85 vs >0.85: 17.8% vs 8.9%, P<0.05) and post-PCI CFR (≤2.26 vs >2.26: 20.5% vs 7.2%, P<0.01), although the reclassification ability for TVF was improved only with post-PCI CFR (net reclassification index 0.598; P<0.01; integrated discrimination index 0.038; P<0.01), but not with post-PCI FFR, in comparison with the clinical model. Compared with patients with FFR >0.85, those with post-PCI FFR ≤0.85 and CFR ≤2.26 showed significantly higher risk of TVF (8.9% vs 28.9%, P<0.01, HR 4.24, 95% CI 2.40–7.50, P<0.01), whereas those with post-PCI FFR <0.85 and CFR >2.26 had similar TVF risk (8.9% vs 9.2%, P=1.00, HR 1.01, 95% CI 0.47–2.16, P=0.97).
Conclusions
After PCI completion with newer-generation DES, discordant results between FFR and CFR were observed in 42.5%. Compared with post-PCI CFR, post-PCI FFR provided limited reclassification ability for TVF. Among patients with lower post-PCI FFR, only patients with lower post-PCI CFR showed significantly higher risk of TVF than those with higher post-PCI FFR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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10
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Nagamine T, Masahiro H, Sayama K, Matsuda K, Ueno H, Misawa T, Hada M, Sugiyama T, Yonetsu T, Sasano T, Kakuta T. Prevalence and culprit lesion plaque characteristics on optical coherence tomography in patients with non-st-segment elevation acute coronary syndrome with zero coronary calcification on coronary CTA. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
CAC evaluated by non-contrast computed tomography is a marker of atherosclerosis. However, the characteristic features of CCTA and optical coherence tomography (OCT) of culprit lesions in patients with NSTE-ACS showing zero CAC remain unknown.
Objectives
This study aimed to assess the prevalence and characteristic features of culprit lesions on coronary CT angiography (CCTA) and optical coherence tomography (OCT) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) showing zero coronary artery calcium (CAC).
Methods
A total of 176 consecutive patients with NSTE-ACS who underwent preprocedural CCTA and OCT were studied. Patients were divided into two groups according to their CAC (zero-CAC and non-zero-CAC groups). Baseline characteristics, CCTA and OCT findings were compared between these two groups.
Results
The prevalence of patients with zero-CACS was 15.9% (28/176). Patients in zero CAC group were younger (mean age, 55 vs. 65 years, P<0.001) and had a lower prevalence of diabetes (10.7 vs 37.2%, P=0.012) than non-zero CAC group. In zero CAC group, the lower prevalence of napkin ring sign (3.5% vs. 28.4%, P=0.028), smaller LV mass index (77.7 vs. 83.9, P=0.04), lower prevalence on spotty calcification (0 vs. 83.8%, P<0.001), lower epicardial fat volume (111.3 vs. 142.6 cm3, P=0.025), and lower pericoronary adipose tissue attenuation (−71.5 vs. −70.2 HU, P=0.07) on CCTA were observed. On OCT, the frequency of plaque erosion (82.1 vs. 44.6%, P<0.001) was significantly higher in zero-CACS group. The prevalence of lipid-rich plaque (46.4 vs. 86.5%, P<0.001), thin-cap fibroatheroma (17.9 vs. 46%, P=0.006), macrophage accumulation (46.4 vs. 81.8%, P<0.001) and cholesterol crystal (7 vs. 41.9%, P<0.001) were all significantly lower in zero-CAC group.
Conclusions
Zero CAC NSTE-ACS was not rare. Zero-CAC NSTE-ACS was characterized by specific phenotypes defined by the combined assessment of CCTA and OCT. Further studies are warranted if these characteristics of NSTE-ACS on preprocedural imaging studies provide prognostic information or guidance of a specific therapeutic approach.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Masahiro
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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11
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Sugiyama T, Kanaji Y, Hoshino M, Hada M, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Relationship between OCT-derived plaque characteristics, CTA-derived coronary inflammation, and CMR-derived global coronary flow reserve in patients with acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The presence of layered plaque is suggestive of recurrent thrombotic events. However, the impact of layered plaque detected by optical coherence tomography (OCT) on coronary inflammation and coronary flow reserve remains unclear.
Purpose
We aimed to investigate the association of OCT-derived layered plaque with pericoronary adipose tissue inflammation assessed by coronary computed tomography angiography (cCTA) and global coronary flow reserve (G-CFR) assessed by cardiac magnetic resonance imaging (CMR) in patients with acute coronary syndrome (ACS).
Methods
We investigated 88 patients with first ACS who underwent preprocedural cCTA and OCT imaging of the culprit lesion, and CMR after percutaneous coronary intervention (PCI). All patients were divided into four groups according to the OCT-derived culprit plaque characteristics: layered vs. non-layered plaque; and plaque rupture vs. plaque erosion. Coronary inflammation was assessed by the mean value of pericoronary adipose tissue (PCAT) attenuation (−190 to −30 HU) of the three major coronary vessels. G-CFR was obtained by quantifying absolute coronary sinus flow at rest and during maximum hyperemia. CCTA and CMR findings were compared between the groups.
Results
In a total of 88 patients, layered plaque [L] with plaque rupture [PR] was observed in 25 patients, layered plaque with plaque erosion [PE] was observed in 26 patients, non-layered plaque [NL] with PR was observed in 23 patients, and non-layered plaque with PE was observed in 14 patients, respectively. Three-vessel-PCAT attenuation value (L-PR vs. L-PE vs. NL-PR vs. NL-PE; −68.13±6.18 vs. −69.01±6.72 vs. −69.76±4.04 vs. −74.61±5.63 HU, P=0.009) and culprit vessel PCAT attenuation value (L-PR vs. L-PE vs. NL-PR vs. NL-PE; −66.39±7.38 vs. −68.94±8.06 vs. −70.01±5.76 vs. −75.45±6.60 HU, P=0.003) showed the graded difference between the four groups. G-CFR value also showed the graded difference between the four groups (L-PR vs. L-PE vs. NL-PR vs. NL-PE; 2.26 [1.80–2.87] vs. 2.24 [1.72–3.13] vs. 2.97 [2.24–3.83] vs. 3.18 [2.67–4.08], P=0.022).
Conclusions
The presence of layered plaque at the culprit lesion was associated with high PCATA and low G-CFR in patients with ACS. Detection of layered plaque may indicate increased pericoronary inflammation and impaired coronary flow reserve, potentially providing the risk stratification in patients with ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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12
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Nakagawara K, Namkoong H, Terai H, Masaki K, Tanosaki T, Shimamoto K, Lee H, Tanaka H, Okamori S, Kabata H, Chubachi S, Ikemura S, Kamata H, Yasuda H, Kawada I, Ishii M, Ishibashi Y, Harada S, Fujita T, Ito D, Bun S, Tabuchi H, Kanzaki S, Shimizu E, Fukuda K, Yamagami J, Kobayashi K, Hirano T, Inoue T, Kagyo J, Shiomi T, Ohgino K, Sayama K, Otsuka K, Miyao N, Odani T, Oyamada Y, Masuzawa K, Nakayama S, Suzuki Y, Baba R, Nakachi I, Kuwahara N, Ishiguro T, Mashimo S, Minematsu N, Ueda S, Manabe T, Funatsu Y, Koh H, Yoshiyama T, Saito F, Ishioka K, Takahashi S, Nakamura M, Goto A, Harada N, Kusaka Y, Nakano Y, Nishio K, Tateno H, Edahiro R, Takeda Y, Kumanogoh A, Kodama N, Okamoto M, Umeda A, Hagimura K, Sato T, Miyazaki N, Takemura R, Sato Y, Takebayashi T, Nakahara J, Mimura M, Ogawa K, Shimmura S, Negishi K, Tsubota K, Amagai M, Goto R, Ibuka Y, Hasegawa N, Kitagawa Y, Kanai T, Fukunaga K. Comprehensive and long-term surveys of COVID-19 sequelae in Japan, an ambidirectional multicentre cohort study: study protocol. BMJ Open Respir Res 2021; 8:8/1/e001015. [PMID: 34836924 PMCID: PMC8628335 DOI: 10.1136/bmjresp-2021-001015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/02/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The rapid spread of COVID-19 posed a global burden. Substantial number of people died of the disease in the acute phase of infection. In addition, a significant proportion of patients have been reported to suffer from post-acute phase symptoms, sequelae of COVID-19, which may negatively influence the quality of daily living and/or socioeconomic circumstances of the patients. However, no previous study has comprehensively and objectively assessed the quality of life of patients by using existing international scales. Further, evidence of socioeconomic consequences among patients with COVID-19 is scarce. To address the multidimensional issues from sequelae of COVID-19, evidence from comprehensive surveys beyond clinical perspectives is critical that investigates health, and social determinants of disease progression as well as socioeconomic consequences at a large scale. METHODS AND ANALYSIS In this study, we plan to conduct a nationwide and comprehensive survey for the sequelae of COVID-19 in a total of 1000 patients diagnosed at 27 hospitals throughout Japan. This study will evaluate not only the health-related status of patients from clinical perspectives but also the Health-related Quality of Life (HRQoL) scores, socioeconomic status and consequences to discuss the sequelae of the disease and the related risk factors. The primary endpoint is the frequency of long-term complications of COVID-19 infection. The secondary endpoints are risk factors for progression to sequelae of COVID-19 infection. The study will provide robust and important evidence as a resource to tackle the issues from the sequelae of COVID-19 from the multi-dimensional perspectives. ETHICS AND DISSEMINATION This trial was approved by the Keio University School of Medicine Ethics Committee (20200243, UMIN000042299). The results of this study will be reported at a society meeting or published in a peer-reviewed journal.
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Affiliation(s)
- Kensuke Nakagawara
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takae Tanosaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kyoko Shimamoto
- Keio Global Research Institute, Keio University, Tokyo, Japan
| | - Ho Lee
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiromu Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Okamori
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kabata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shinnosuke Ikemura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hirofumi Kamata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiki Ishibashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Sei Harada
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Fujita
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Ito
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Shogyoku Bun
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Sho Kanzaki
- Department of Otolaryngology, Keio University School of Medicine, Tokyo, Japan
| | - Eisuke Shimizu
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Keitaro Fukuda
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Jun Yamagami
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Keigo Kobayashi
- Department of Internal Medicine, Sano Kosei General Hospital, Tochigi, Japan
| | - Toshiyuki Hirano
- Department of Internal Medicine, Sano Kosei General Hospital, Tochigi, Japan
| | - Takashi Inoue
- Department of Internal Medicine, Sano Kosei General Hospital, Tochigi, Japan
| | - Junko Kagyo
- Department of Internal Medicine, Keiyu Hospital, Kanagawa, Japan
| | - Tetsuya Shiomi
- Department of Internal Medicine, Keiyu Hospital, Kanagawa, Japan
| | - Keiko Ohgino
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Kengo Otsuka
- Department of Internal Medicine, Nihon Koukan Hospital, Kanagawa, Japan
| | - Naoki Miyao
- Department of Internal Medicine, Nihon Koukan Hospital, Kanagawa, Japan
| | - Toshio Odani
- Department of Rheumatology, National Hospital Organization Hokkaido Medical Center, Hokkaido, Japan
| | - Yoshitaka Oyamada
- Department of Respiratory Medicine, National Hospital Organisation Tokyo Medical Center, Tokyo, Japan
| | - Keita Masuzawa
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Sohei Nakayama
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Yusuke Suzuki
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Rie Baba
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Ichiro Nakachi
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Naota Kuwahara
- Department of Medicine, Division of Allergology and Respiratory Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
| | - Shuko Mashimo
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, Aichi, Japan
| | - Naoto Minematsu
- Department of Internal Medicine, Hino Municipal Hospital, Tokyo, Japan
| | - Soichiro Ueda
- Department of Internal Medicine, Saitama Medical Center, Saitama, Japan
| | - Tadashi Manabe
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, Tokyo, Japan
| | - Yohei Funatsu
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, Tokyo, Japan
| | - Hidefumi Koh
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, Tokyo, Japan
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital,Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Fumitake Saito
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Kota Ishioka
- Department of Pulmonary Medicine, Saiseikai Central Hospital, Tokyo, Japan
| | - Saeko Takahashi
- Department of Pulmonary Medicine, Saiseikai Central Hospital, Tokyo, Japan
| | - Morio Nakamura
- Department of Pulmonary Medicine, Saiseikai Central Hospital, Tokyo, Japan
| | - Ai Goto
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Norihiro Harada
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Yu Kusaka
- Department of Respiratory Medicine, Ome Municipal General Hospital, Ome, Tokyo, Japan
| | - Yasushi Nakano
- Department of Pulmonary Medicine, Kawasaki Municipal Ida Hospital, Kanagawa, Japan
| | - Kazumi Nishio
- Department of Pulmonary Medicine, Kawasaki Municipal Ida Hospital, Kanagawa, Japan
| | - Hiroki Tateno
- Department of Pulmonary Medicine, Saitama City Hospital, Saitama, Japan
| | - Ryuya Edahiro
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshito Takeda
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobuhiro Kodama
- Department of General Internal Medicine, Fukuoka Tokushukai Hospitali, Fukuoka, Japan
| | - Masaki Okamoto
- Department of Internal Medicine, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Akira Umeda
- Department of Respiratory Medicine, International University of Health and Welfare Shioya Hospital, Tochigi, Japan
| | - Kazuto Hagimura
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Toshiro Sato
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Miyazaki
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Ryo Takemura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Yasunori Sato
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kaoru Ogawa
- Department of Otolaryngology, Keio University School of Medicine, Tokyo, Japan
| | - Shigeto Shimmura
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Rei Goto
- Graduate School of Business Administration, Keio University, Tokyo, Japan
| | - Yoko Ibuka
- Faculty of Economics, Keio University, Tokyo, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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13
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Arai D, Sato T, Nakachi I, Fujisawa D, Takeuchi M, Sato Y, Kawada I, Yasuda H, Ikemura S, Terai H, Nukaga S, Inoue T, Nakamura M, Oyamada Y, Terashima T, Sayama K, Saito F, Sakamaki F, Naoki K, Fukunaga K, Soejima K. Longitudinal Assessment of Prognostic Understanding in Patients with Advanced Lung Cancer and Its Association with Their Psychological Distress. Oncologist 2021; 26:e2265-e2273. [PMID: 34510654 DOI: 10.1002/onco.13973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/19/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Accurate prognostic understanding in patients with advanced cancer is essential for shared decision making; however, patients may experience psychological burden through knowing the incurable nature of advanced cancer. It has been unclear how their prognostic understanding fluctuates and whether accurate prognostic understanding is associated with psychological distress from the time of diagnosis over time. MATERIALS AND METHODS We longitudinally investigated prognostic understanding in 225 patients with newly diagnosed advanced lung cancer at 16 hospitals in Japan until 24 months after diagnosis. We examined associated factors with being consistently accurate in prognostic understanding, especially focusing on its association with psychological well-being. RESULTS The proportion of patients with an inaccurate prognostic understanding remained approximately 20% over time with the presence of patients with inconsistent understanding. Patients with consistently accurate prognostic understanding showed a significantly lower Emotional Well-Being subscale score at both 3 and 6 months after diagnosis (p = .010 and p = .014, respectively). In multivariate analyses, being consistently accurate in prognostic understanding was significantly associated with female gender and higher lung cancer-specific symptom burden at 3 months (p = .008 and p = .005, respectively) and lower emotional well-being at 6 months (p = .006). CONCLUSION Although substantial proportions of patients with advanced lung cancer had inaccurate prognostic understanding from the time of diagnosis over time, patients with consistently accurate prognostic understanding experienced greater psychological burden. Our findings highlight the importance of continuous psychological care and support for patients who understand their severe prognosis accurately. IMPLICATIONS FOR PRACTICE This study demonstrated that approximately 20% of patients with advanced lung cancer had an inaccurate understanding about their prognosis, not only at the time of diagnosis but also at the later time points. Being consistently accurate in prognostic understanding was significantly associated with elevated levels of psychological distress. Although accurate prognostic understanding is essential for decision making for treatment and advance care planning, health care providers should be aware of psychological burdens in patients that accept their severe prognosis accurately. Appropriate care and support for such patients are warranted from diagnosis over time.
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Affiliation(s)
- Daisuke Arai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Takashi Sato
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Medicine, Keiyu Hospital, Yokohama, Japan
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Ichiro Nakachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Daisuke Fujisawa
- Division of Patient Safety, Keio University School of Medicine, Tokyo, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Mari Takeuchi
- Palliative Care Center, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shinnosuke Ikemura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Shigenari Nukaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takashi Inoue
- Department of Internal Medicine, Sano-Kosei General Hospital, Sano, Japan
| | - Morio Nakamura
- Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Yoshitaka Oyamada
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Terashima
- Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, Kawasaki, Japan
| | - Fumitake Saito
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Fumio Sakamaki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University Hachioji Hospital, Hachioji, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kenzo Soejima
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
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14
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Doi C, Muto J, Yatsuzuka K, Iwata H, Sayama K. A case of aplasia cutis congenita type VII with tibial dysplasia. Clin Exp Dermatol 2021; 47:412-413. [PMID: 34407227 DOI: 10.1111/ced.14900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- C Doi
- Departments of, Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - J Muto
- Departments of, Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - K Yatsuzuka
- Departments of, Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - H Iwata
- Department of, Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - K Sayama
- Departments of, Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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15
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Sato T, Fujisawa D, Arai D, Nakachi I, Takeuchi M, Nukaga S, Kobayashi K, Ikemura S, Terai H, Yasuda H, Kawada I, Sato Y, Satomi R, Takahashi S, Hashiguchi MH, Nakamura M, Oyamada Y, Terashima T, Sayama K, Saito F, Sakamaki F, Inoue T, Naoki K, Fukunaga K, Soejima K. Trends of concerns from diagnosis in patients with advanced lung cancer and their family caregivers: A 2-year longitudinal study. Palliat Med 2021; 35:943-951. [PMID: 33761790 PMCID: PMC8114458 DOI: 10.1177/02692163211001721] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Both advanced cancer patients and their family caregivers experience distress and have a range of concerns after cancer diagnosis. However, longitudinal studies on this topic have been lacking. AIM To investigate concerns in both patients with advanced lung cancer and their family caregivers longitudinally from diagnosis. DESIGN A multi-center prospective questionnaire-based study. SETTING/PARTICIPANTS We recruited patients with newly diagnosed advanced lung cancer and their family caregivers at 16 hospitals in Japan. We prospectively assessed the prevalence of their concerns using the Concerns Checklist and investigated the associations between their concerns and mental status as well as quality of life until 24 months after diagnosis. RESULTS A total of 248 patients and their 232 family caregivers were enrolled. The prevalence of serious concerns was highest at diagnosis (patients: 68.3%, family caregivers: 65.3%). The most common serious concern was concern about the future in both groups at diagnosis (38.2% and 40.5%, respectively) and this remained high in prevalence over time, while the high prevalence of concern about lack of information improved 3 months after diagnosis in both groups. Approximately one-third of patient-family caregiver dyads had discrepant reports of serious concerns. The presence of serious concerns was significantly associated with anxiety and depression continuously in both groups. CONCLUSIONS The majority of advanced lung cancer patients and their family caregivers have serious concerns from diagnosis, which is associated with their psychological distress. The spectrum of concerns alters over the disease trajectory, warranting efficient tailored care and support for both groups immediately after diagnosis.
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Affiliation(s)
- Takashi Sato
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Medicine, Keiyu Hospital, Yokohama, Japan.,Department of Medicine, Sano-kosei General Hospital, Sano, Japan
| | - Daisuke Fujisawa
- Division of Patient Safety, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Arai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Pulmonary division, Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Ichiro Nakachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Pulmonary division, Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Mari Takeuchi
- Palliative Care Center, Keio University Hospital, Tokyo, Japan
| | - Shigenari Nukaga
- Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Keigo Kobayashi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Medicine, Sano-kosei General Hospital, Sano, Japan
| | - Shinnosuke Ikemura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Ryosuke Satomi
- Department of Medicine, Sano-kosei General Hospital, Sano, Japan.,Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Saeko Takahashi
- Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Mizuha Haraguchi Hashiguchi
- Department of Medicine, Keiyu Hospital, Yokohama, Japan.,Department of Respiratory Medicine, Nippon Kokan Hospital, Kawasaki, Japan
| | - Morio Nakamura
- Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Yoshitaka Oyamada
- Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Terashima
- Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, Kawasaki, Japan
| | - Fumitake Saito
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Fumio Sakamaki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan
| | - Takashi Inoue
- Department of Medicine, Sano-kosei General Hospital, Sano, Japan
| | - Katsuhiko Naoki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kenzo Soejima
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
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16
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Tanosaki T, Kabata H, Matsusaka M, Miyata J, Masaki K, Mochimaru T, Okuzumi S, Kuwae M, Watanabe R, Suzuki Y, Sayama K, Izuhara K, Asano K, Fukunaga K. Clinical characteristics of patients with not well-controlled severe asthma in Japan: Analysis of the Keio Severe Asthma Research Program in Japanese population (KEIO-SARP) registry. Allergol Int 2021; 70:61-67. [PMID: 32651123 DOI: 10.1016/j.alit.2020.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 05/25/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Multiple phenotypes exist within the classification of severe asthma. However, characteristics of patients with not well-controlled severe asthma have not been well identified. METHODS Japanese patients with asthma (age ≥ 20 years) were enrolled at the Keio University Hospital and its affiliated hospitals in this observational study (Keio Severe Asthma Research Program). Among them, patients with severe asthma (those undergoing Global Initiative for Asthma [GINA] 2018 step 4 or 5 treatment) were included in this analysis and investigated clinical characteristics based on asthma control status. RESULTS Of the 154 patients (men, 46.8%; age, 60.1 ± 14.9 years), 87 (56.5%) had not well-controlled (partly controlled and uncontrolled) asthma (GINA step 4, 42 patients; step 5, 45 patients). Overall, there were no significant differences in clinical characteristics between patients with well-controlled and not well-controlled asthma. However, cluster analysis revealed that distinct 5 clusters (cluster 1, well-controlled; cluster 2, eosinophilic; cluster 3, non-type 2 inflammation; cluster 4, high periostin; and cluster 5, late-onset type 2 inflammation), and clusters 2-5 were not well-controlled. Among them, cluster 3 was characterized by low eosinophil counts, low periostin levels, and less frequent olfactory disturbance, and this cluster had the worst asthma control. CONCLUSIONS Japanese patients with severe asthma were divided into well-controlled and not-well controlled asthma, and we confirmed heterogeneity of not well-controlled severe asthma. These patients, especially non-type 2 phenotype, require a further therapeutic approach. (University Hospital Medical Information Network Clinical Trials Registry, UMIN000002980).
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Affiliation(s)
- Takae Tanosaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kabata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masako Matsusaka
- Department of Laboratory of Bioregulatory Medicine, Kitasato University School of Pharmacy, Tokyo, Japan
| | - Jun Miyata
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takao Mochimaru
- Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Shinichi Okuzumi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Misato Kuwae
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Risa Watanabe
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Koichi Sayama
- Respiratory Medicine, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
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17
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Yoshida S, Shiraishi K, Mito T, Sayama K. Vogt–Koyanagi–Harada‐like syndrome induced by immune checkpoint inhibitors in a patient with melanoma. Clin Exp Dermatol 2020; 45:908-911. [DOI: 10.1111/ced.14282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/24/2020] [Accepted: 05/05/2020] [Indexed: 11/29/2022]
Affiliation(s)
- S. Yoshida
- Departments of Department of Dermatology Ehime University Graduate School of Medicine Toon, Ehime Japan
| | - K. Shiraishi
- Departments of Department of Dermatology Ehime University Graduate School of Medicine Toon, Ehime Japan
| | - T. Mito
- Department of Ophthalmology Ehime University Graduate School of Medicine Toon, Ehime Japan
| | - K. Sayama
- Departments of Department of Dermatology Ehime University Graduate School of Medicine Toon, Ehime Japan
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18
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Muto J, Fukuda S, Shirakata Y, Tsuda T, Tan E, Dai X, Shiraishi K, Mori H, Murakami M, Higashiyama S, Sayama K. 796 Effect of novel disaccharide for construction of living skin equivalents. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Ueda S, Fukunaga K, Takihara T, Shiraishi Y, Oguma T, Shiomi T, Suzuki Y, Ishii M, Sayama K, Kagawa S, Hirai H, Nagata K, Nakamura M, Miyasho T, Betsuyaku T, Asano K. Deficiency of CRTH2, a Prostaglandin D 2 Receptor, Aggravates Bleomycin-induced Pulmonary Inflammation and Fibrosis. Am J Respir Cell Mol Biol 2019; 60:289-298. [PMID: 30326727 DOI: 10.1165/rcmb.2017-0397oc] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Chemoattractant receptor homologous with T-helper cell type 2 cells (CRTH2), a receptor for prostaglandin D2, is preferentially expressed on T-helper cell type 2 lymphocytes, group 2 innate lymphoid cells, eosinophils, and basophils, and elicits the production of type 2 cytokines, including profibrotic IL-13. We hypothesized that lack of CRTH2 might protect against fibrotic lung disease, and we tested this hypothesis using a bleomycin-induced lung inflammation and fibrosis model in CRTH2-deficient (CRTH2-/-) or wild-type BALB/c mice. Compared with wild-type mice, CRTH2-/- mice treated with bleomycin exhibited significantly higher mortality, enhanced accumulation of inflammatory cells 14-21 days after bleomycin injection, reduced pulmonary compliance, and increased levels of collagen and total protein in the lungs. These phenotypes were associated with decreased levels of IFN-γ, IL-6, IL-10, and IL-17A in BAL fluid. Adoptive transfer of splenocytes from wild-type, but not CRTH2-/-, mice 2 days before injection of bleomycin resolved the sustained inflammation as well as the increased collagen and protein accumulation in the lungs of CRTH2-/- mice. We consider that the disease model is driven by γδT cells that express CRTH2; thus, the adoptive transfer of γδT cells could ameliorate bleomycin-induced alveolar inflammation and fibrosis.
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Affiliation(s)
- Soichiro Ueda
- 1 Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- 1 Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takahisa Takihara
- 2 Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Yoshiki Shiraishi
- 2 Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tsuyoshi Oguma
- 2 Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tetsuya Shiomi
- 1 Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- 1 Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Ishii
- 1 Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Sayama
- 1 Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shizuko Kagawa
- 1 Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Hirai
- 3 Department of Advanced Medicine and Development, Bio Medical Laboratories, Inc., Saitama, Japan
| | - Kinya Nagata
- 3 Department of Advanced Medicine and Development, Bio Medical Laboratories, Inc., Saitama, Japan
| | - Masataka Nakamura
- 4 Human Gene Sciences Center, Tokyo Medical and Dental University, Tokyo, Japan; and
| | - Taku Miyasho
- 5 Department of Veterinary Science, School of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
| | - Tomoko Betsuyaku
- 1 Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Asano
- 2 Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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20
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Murakami M, Muto J, Kameda K, Mori H, Utsunomiya R, Shiraishi K, Sayama K. 205 The histological pustulovesicle-like features of pompholyx: the specific component different from palmoplantar pustulosis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Mori H, Murakami M, Muto J, Utsunomiya R, Kameda K, Matsuma S, Shiraishi K, Sayama K. 640 Suppressive effect of HMGB1 A-box for inflammation in keratinocytes. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Murakami M, Muto J, Masuda-Kuroki K, Tsuda T, Mori H, Utsunomiya R, Shiraishi K, Sayama K. Pompholyx vesicles contain small clusters of cells with high levels of hyaluronate resembling the pustulovesicles of palmoplantar pustulosis. Br J Dermatol 2019; 181:1325-1327. [PMID: 31254390 DOI: 10.1111/bjd.18261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M Murakami
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - J Muto
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - K Masuda-Kuroki
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - T Tsuda
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - H Mori
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - R Utsunomiya
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - K Shiraishi
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - K Sayama
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
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23
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Ogawa T, Tanaka K, Ohgino K, Omori N, Betsuyaku T, Sayama K. Drug-induced pneumonitis following the administration of laninamivir octanoate: The first two reported cases. J Infect Chemother 2019; 25:1043-1046. [PMID: 31178281 DOI: 10.1016/j.jiac.2019.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 04/15/2019] [Accepted: 05/15/2019] [Indexed: 10/26/2022]
Abstract
Laninamivir, a neuraminidase inhibitor (NAI), has been used for the treatment and prophylaxis of influenza A/B. To date, pneumonia has not been reported as an adverse effect of NAIs. Here, we report the first 2 cases of drug-induced pneumonitis after the administration of laninamivir octanoate (LO), a pro-drug of laninamivir. Case 1 reports a 20-year-old healthy woman presenting with LO-induced pneumonitis so severe that it was necessary for endotracheal intubation and administration of mechanical ventilator support. Steroids were used for the treatment of pneumonitis and rapid improvement was observed. Case 2 reports a 35-year-old healthy woman presenting with less severe LO-induced pneumonitis that improved without any treatment. In both cases, drug-induced lymphocyte stimulation tests (DLSTs) were positive. In the bronchoalveolar lavage (BAL) fluid, the proportion of eosinophils to lymphocytes was higher in Case 1. Conversely, the proportion of lymphocytes to eosinophils was higher in Case 2. Collectively, we determined 3 clinical issues: (1) LO could cause pneumonia; (2) BAL and DLST could be helpful in the diagnosis of LO-induced pneumonitis; and (3) LO-induced pneumonia could become severe, though steroids were effective in improving it.
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Affiliation(s)
- Takunori Ogawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan; Kawasaki Municipal Hospital, Kanagawa, Japan
| | | | | | - Nao Omori
- Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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24
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Kameyama N, Chubachi S, Sasaki M, Tsutsumi A, Irie H, Sakurai K, Sayama K, Nakamura H, Asano K, Betsuyaku T, Fukunaga K. Predictive and modifying factors of bone mineral density decline in patients with COPD. Respir Med 2019; 148:13-23. [PMID: 30827469 DOI: 10.1016/j.rmed.2019.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 01/31/2023]
Abstract
RATIONALE Various determinants of osteoporosis have been previously identified. However, only a few longitudinal studies have examined related factors. We aimed to investigate factors predicting and modifying rapid decline of bone mineral density in patients with chronic obstructive pulmonary disease. METHODS We analyzed patients with chronic obstructive pulmonary disease whose bone mineral density were measured at least three times over three years (n = 111). We divided annual per cent changes of bone mineral density in different body parts into tertiles. Rapid decliners (n = 33) were defined as those with the largest decline in at least two parts; all other participants were defined as non-rapid decliners (n = 78). RESULTS At enrollment, bone mineral density did not differ between the two groups. However, rapid decliners had a significantly greater rate of new vertebral fractures over 3 years compared with non-rapid decliners. On multivariate logistic regression analysis, age, moderate to severe emphysema, no daily exercise habits, and anemia increased the likelihood of rapid decliners. Furthermore, patients who newly started and continued bisphosphonate exhibited higher annual per cent changes of bone mineral density than did those without bisphosphonate use. CONCLUSIONS A rapid decline in bone mineral density correlates to a higher likelihood of vertebral fracture. We clarified the predictors of bone mineral density decline and demonstrated that bisphosphonate use might modify bone mineral density in patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Naofumi Kameyama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Mamoru Sasaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Akihiro Tsutsumi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hidehiro Irie
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kaori Sakurai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki-shi, Kanagawa, 210-0013, Japan
| | - Hidetoshi Nakamura
- Division of Pulmonary Medicine, Saitama Medical University Hospital, 38 Morohongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Sato T, Soejima K, Fujisawa D, Takeuchi M, Arai D, Nakachi I, Naoki K, Kawada I, Yasuda H, Ishioka K, Nukaga S, Kobayashi K, Masaki K, Inoue T, Hikima K, Nakamura M, Ohgino K, Oyamada Y, Funatsu Y, Terashima T, Miyao N, Sayama K, Saito F, Sakamaki F, Betsuyaku T. Prognostic Understanding at Diagnosis and Associated Factors in Patients with Advanced Lung Cancer and Their Caregivers. Oncologist 2018; 23:1218-1229. [PMID: 30120158 DOI: 10.1634/theoncologist.2017-0329] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/21/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Prognostic understanding in advanced cancer patients and their caregivers may have an impact on the delivery of effective care. The aims of this study were to explore prognostic understanding at diagnosis in both patients with advanced lung cancer and their caregivers and to investigate correlates of their understanding. SUBJECTS, MATERIALS, AND METHODS A total of 193 patients with newly diagnosed advanced lung cancer and their 167 caregivers were enrolled at 16 hospitals in Japan. We assessed their perceptions of prognosis and goals of therapy and examined their associations with their sociodemographic characteristics, clinical status, quality of life, mood symptoms, and the status of disclosure of information by their treating physicians. RESULTS One fifth of patients and caregivers (21.7% and 17.6%, respectively) mistakenly believed that the patients' cancer was "completely curable." Substantial proportions of them (16.9% and 10.3%, respectively) mistakenly believed that the primary goal of therapy was to remove all the cancer. Levels of anxiety and depression in both patients and caregivers were significantly higher among those who had accurate understanding of prognosis. In multivariate analyses, inaccurate perceptions of prognosis in patients were associated with sex, better emotional well-being, and lower lung cancer-specific symptom burden. Caregivers' inaccurate perceptions of patients' prognoses were associated with better performance status and better emotional well-being of patients. CONCLUSION Substantial proportions of advanced lung cancer patients and their caregivers misunderstood their prognosis. Interventions to improve their accurate prognostic understanding should be developed with careful attention paid to its associated factors. IMPLICATIONS FOR PRACTICE This study demonstrated that substantial proportions of patients with newly diagnosed advanced lung cancer and their caregivers had misunderstandings about their prognosis. Accurate perceptions of prognosis, which are indispensable in the delivery of effective care, were associated with elevated levels of anxiety and depression in both patients and caregivers, warranting psychosocial care and support for them immediately after diagnosis. Inaccurate perceptions of prognosis in patients were associated with better emotional well-being and lower lung cancer-specific symptom burden. Illness understanding in caregivers was associated with patients' physical and mental status. Those findings provide insight into how they obtain accurate illness understanding.
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Affiliation(s)
- Takashi Sato
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Sano-kosei General Hospital, Sano, Japan
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Kenzo Soejima
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Palliative Care Center, Keio University Hospital, Tokyo, Japan
| | - Mari Takeuchi
- Palliative Care Center, Keio University Hospital, Tokyo, Japan
| | - Daisuke Arai
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
- Pulmonary Division, Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Ichiro Nakachi
- Pulmonary Division, Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Katsuhiko Naoki
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kota Ishioka
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shigenari Nukaga
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Keigo Kobayashi
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Katsunori Masaki
- Pulmonary Division, Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Takashi Inoue
- Department of Internal Medicine, Sano-kosei General Hospital, Sano, Japan
| | - Kota Hikima
- Department of Internal Medicine, Sano-kosei General Hospital, Sano, Japan
| | - Morio Nakamura
- Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Keiko Ohgino
- Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Yoshitaka Oyamada
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yohei Funatsu
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Terashima
- Department of Respiratory Medicine, Tokyo Dental College, Chiba, Japan
| | - Naoki Miyao
- Department of Respiratory Medicine, Nippon Kokan Hospital, Kanagawa, Japan
| | | | - Fumitake Saito
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Fumio Sakamaki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University Hachioji Hospital, Tokyo, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Masuda K, Murakami M, Tokunaga N, Kishibe M, Mori H, Utsunomiya R, Tsuda T, Shiraishi K, Tohyama M, Sayama K. 390 The micribome exists in the 'sterile' pustule of palmoplantar pustulosis. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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27
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Mori H, Murakami M, Utsunomiya R, Masuda K, Shiraishi K, Dai X, Tohyama M, Sayama K. 911 New role of exogenous HMGB1 for human keratinocyte under acute inflammatory event. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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28
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Kobayashi K, Nakachi I, Naoki K, Satomi R, Nakamura M, Inoue T, Tateno H, Sakamaki F, Sayama K, Terashima T, Koh H, Abe T, Nishino M, Arai D, Yasuda H, Kawada I, Soejima K, Betsuyaku T. Real-world Efficacy and Safety of Nivolumab for Advanced Non-Small-cell Lung Cancer: A Retrospective Multicenter Analysis. Clin Lung Cancer 2018; 19:e349-e358. [PMID: 29398578 DOI: 10.1016/j.cllc.2018.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 12/20/2017] [Accepted: 01/01/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Nivolumab, an immune checkpoint inhibitor, is now a standard treatment for previously treated advanced non-small-cell lung cancer based on the results from phase III clinical trials. We evaluated the real-world efficacy and safety of nivolumab in a nonselected population and identified the clinical characteristics that influence efficacy. MATERIALS AND METHODS A total of 142 patients with advanced non-small-cell lung cancer who were administered nivolumab at Keio University and affiliated hospitals in Japan from January to July 2016 were enrolled. The treatment efficacy and adverse events were retrospectively reviewed, and the clinical characteristics associated with the nivolumab response were evaluated using univariate and stratified analyses and the Cochran-Mantel-Haenszel test. RESULTS The objective response rate was 17.0% (95% confidence interval [CI], 12.0%-24.0%), the median progression-free survival (PFS) was 58 days (95% CI, 50-67 days), and the proportion of patients with adverse events of any grade was 45.0%. EGFR/ALK mutation status was inversely associated with the treatment response (P < .05), and the difference in PFS for the mutation-positive versus mutation-negative patients was statistically significant (49 vs. 63 days; hazard ratio, 1.9; 95% CI, 1.1-5.2; P = .029). Previous radiotherapy also had a positive association with the treatment response (P = .012). CONCLUSION The objective response rate, PFS, and adverse event profiles were comparable to those observed in previous clinical trials. EGFR/ALK mutation-negative status and previous radiotherapy might be key clinical characteristics associated with a positive treatment response. Our findings could aid in the efficient immunotherapeutic management of lung cancer.
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Affiliation(s)
- Keigo Kobayashi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Nakachi
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
| | - Katsuhiko Naoki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ryosuke Satomi
- National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | | | | | | | | | | | | | | | - Takayuki Abe
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Nishino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Arai
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kenzo Soejima
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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Abstract
Solar energy can be effectively accumulated by the control of the absorbed Fe(iii) amount.
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Affiliation(s)
- Y. Miseki
- Advanced Functional Materials Team
- Research Center for Photovoltaics (RCPV)
- National Institute of Advanced Industrial Science and Technology (AIST)
- Tsukuba
- Japan
| | - K. Sayama
- Advanced Functional Materials Team
- Research Center for Photovoltaics (RCPV)
- National Institute of Advanced Industrial Science and Technology (AIST)
- Tsukuba
- Japan
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Oda F, Murakami M, Hanakawa Y, Tohyama M, Nakano N, Nishikomori R, Kambe N, Sayama K. A sporadic case of granulomatous disease negative for NOD2
mutations and mimicking Blau syndrome. Clin Exp Dermatol 2017; 43:57-58. [DOI: 10.1111/ced.13217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2016] [Indexed: 11/30/2022]
Affiliation(s)
- F. Oda
- Department of Dermatology; Ehime University Graduate School of Medicine; Shitsukawa, Toon-City Ehime 791-0295 Japan
| | - M. Murakami
- Department of Dermatology; Ehime University Graduate School of Medicine; Shitsukawa, Toon-City Ehime 791-0295 Japan
| | - Y. Hanakawa
- Department of Dermatology; Ehime University Graduate School of Medicine; Shitsukawa, Toon-City Ehime 791-0295 Japan
| | - M. Tohyama
- Department of Dermatology; Ehime University Graduate School of Medicine; Shitsukawa, Toon-City Ehime 791-0295 Japan
| | - N. Nakano
- Department of Pediatrics; Ehime University Graduate School of Medicine; Shitsukawa, Toon-city Ehime 791-0295 Japan
| | - R. Nishikomori
- Department of Pediatrics; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - N. Kambe
- Department of Dermatology; Kansai Medical University; Osaka Japan
| | - K. Sayama
- Department of Dermatology; Ehime University Graduate School of Medicine; Shitsukawa, Toon-City Ehime 791-0295 Japan
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Mori H, Murakami M, Utsunomiya R, Masuda K, Shiraishi K, Dai X, Tohyama M, Sayama K. 369 Newly discovered function of reduced-HMGB1 as an inflammation suppressor in keratinocytes. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Utsunomiya R, Okazaki H, Dai X, Murakami M, Masuda K, Mori H, Shiraishi K, Tohyama M, Sayama K. 449 Novel function of heparinoid as an anti-inflammatory agent. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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33
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Kobayashi K, Nakachi I, Naoki K, Oyamada Y, Nakamura M, Inoue T, Tateno H, Sakamaki F, Sayama K, Terashima T, Koh H, Arai D, Yasuda H, Kawada I, Soejima K, Betsuyaku T. Practical effectiveness efficacy and safety of nivolumab for advanced non-small cell lung cancer: A retrospective multicenter analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Masaki K, Fukunaga K, Matsusaka M, Kabata H, Tanosaki T, Mochimaru T, Kamatani T, Ohtsuka K, Baba R, Ueda S, Suzuki Y, Sakamaki F, Oyamada Y, Inoue T, Oguma T, Sayama K, Koh H, Nakamura M, Umeda A, Kamei K, Izuhara K, Asano K, Betsuyaku T. Characteristics of severe asthma with fungal sensitization. Ann Allergy Asthma Immunol 2017; 119:253-257. [PMID: 28801088 DOI: 10.1016/j.anai.2017.07.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/11/2017] [Accepted: 07/05/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Some patients with severe asthma also have fungal sensitization and are considered to have severe asthma with fungal sensitization. However, there is limited information on the clinical features of SAFS. OBJECTIVE To investigate the clinical characteristics of severe asthma with fungal sensitization. METHODS The present study enrolled 124 patients with severe asthma. We evaluated clinical aspects, such as various serum cytokines, fractional exhaled nitric oxide, pulmonary function, and serum immunoglobulin E (IgE). Fungal sensitization was assessed by determining serum levels of IgE specific to fungal allergens (Aspergillus, Alternaria, Candida, Cladosporium, Penicillium, and Trichophyton species and Schizophyllum commune). The protocol was registered at a clinical trial registry (www.umin.ac.jp/ctr/index-j.htm; UMIN 000002980). RESULTS Thirty-six patients (29%) showed sensitization to at least 1 fungal allergen. The most common species were Candida (16%), Aspergillus (11%), and Trichophyton (11%). The rate of early-onset asthma (<16 years of age) was higher in patients with fungal sensitization than in those without fungal sensitization (45% vs 25%; P = .02). Interleukin-33 levels were higher in patients with fungal sensitization than in those without fungal sensitization. Of patients with atopic asthma, Asthma Control Test scores were worse in patients with multiple fungal sensitizations than in patients with a single fungal sensitization or those without fungal sensitization. CONCLUSION Severe asthma with fungal sensitization is characterized by early onset of disease and high serum levels of interleukin-33. Multiple fungal sensitizations are associated with poor asthma control. TRIAL REGISTRATION UMIN Clinical Trials Registry (UMIN-CTR; www.umin.ac.jp/ctr/index-j.htm): UMIN 000002980.
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Affiliation(s)
- Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan.
| | - Masako Matsusaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Hiroki Kabata
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Takae Tanosaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Takao Mochimaru
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Takashi Kamatani
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Kengo Ohtsuka
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Rie Baba
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Soichiro Ueda
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- Department of Respiratory Medicine, Kitasato Institute Hospital, Tokyo, Japan
| | - Fumio Sakamaki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University Hachioji Hospital, Tokyo, Japan
| | - Yoshitaka Oyamada
- Department of Respiratory Medicine, Tokyo Medical Center, Tokyo, Japan
| | - Takashi Inoue
- Department of Medicine, Sano Kosei General Hospital, Tochigi, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University, School of Medicine, Kanagawa, Japan
| | - Koichi Sayama
- Department of Medicine, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Hidefumi Koh
- Department of Medicine, KKR-Tachikawa Hospital, Tokyo, Japan
| | - Morio Nakamura
- Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Akira Umeda
- Department of Medicine, Shioya Hospital, International University of Health and Welfare, Tochigi, Japan
| | - Katsuhiko Kamei
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University, School of Medicine, Kanagawa, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
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35
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Kobayashi K, Naoki K, Nakachi I, Oyamada Y, Nakamura M, Inoue T, Tateno H, Sakamaki F, Sayama K, Terashima T, Ko H, Nishino M, Masuzawa K, Hasegawa H, Manabe T, Arai D, Yasuda H, Kawada I, Soejima K, Betsuyaku T. The efficacy and safety of nivolumab in advanced non-small cell lung cancer in clinical practice in Japan: A multicenter analysis. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20577 Background: Nivolumab, an immune checkpoint inhibitor, is now approved as standard treatment for pre-treated advanced non-small cell lung cancer (NSCLC) based on the results from mega clinical trials with carefully selected patients. We sought to clarify the real-world efficacy and safety of nivolumab and to identify the clinical factors influencing the efficacy. Methods: This study enrolled 142 patients with pre-treated advanced NSCLC who had been administered nivolumab (3mg/kg, Q2W) from January to July 2016 at Keio University and affiliated hospitals in Japan. We retrospectively evaluated objective responses, adverse events (AEs), and analysed clinical factors associated with the response. Results: The overall response rate and disease control rate were 17% and 62%, respectively. The rate of any grade AEs was 45%, while the rate of grade 3-4 AEs was 13%. Among patient’s clinical factors such as age, gender, ECOG performance status, types of carcinoma, epidermal growth factor receptor ( EGFR)/ anaplastic lymphoma receptor tyrosine kinase (ALK) mutation status, smoking status, number of previous treatment lines, presence of central nervous system (CNS) metastasis and presence of prior radiotherapy, “ EGFR/ALK mutation negative” and “administration of prior radiotherapy” were independently associated with the good response to nivolumab treatment by multivariate logistic regression analysis (OR NA/ p < 0.01, OR 5.4/ p < 0.01, respectively). None of the 19 EGFR/ALK mutation positive patients showed response. Although a significant difference was not recognized between “current, former smokers” and “never smokers” (chi-square test, p = 0.1), a subsequent analysis showed smoking pack years (PY) was significantly higher in responders than in non-responders ( t-test, p = 0.035). Conclusions: The objective responses and the profiles of AEs confirmed in our study were similar to those observed in Checkmate 057/017 trials. We can use nivolumab safely regardless of age or number of treatment lines. EGFR/ALK mutation and presence of prior radiotherapy were key clinical factors statistically associated with the nivolumab efficacy.
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36
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Miyawaki M, Naoki K, Yoda S, Nakayama S, Satomi R, Sato T, Ikemura S, Ohgino K, Ishioka K, Arai D, Namkoong H, Otsuka K, Miyazaki M, Tani T, Kuroda A, Nishino M, Yasuda H, Kawada I, Koh H, Nakamura M, Terashima T, Sakamaki F, Sayama K, Betsuyaku T, Soejima K. Erlotinib as second- or third-line treatment in elderly patients with advanced non-small cell lung cancer: Keio Lung Oncology Group Study 001 (KLOG001). Mol Clin Oncol 2017; 6:409-414. [PMID: 28451422 DOI: 10.3892/mco.2017.1154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 12/12/2016] [Indexed: 01/05/2023] Open
Abstract
The aim of this study was to assess the efficacy and safety of erlotinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), as second- or third-line treatment for elderly Japanese patients with non-small-cell lung cancer (NSCLC). The patients eligible for this phase II trial were aged ≥70 years, had stage III/IV or recurrent NSCLC, and had previously received 1 or 2 chemotherapy regimens that did not include EGFR-TKIs. The patients received erlotinib at a dose of 150 mg/day. The primary endpoint was overall response rate (ORR), and the secondary endpoints were progression-free survival (PFS), overall survival (OS) and toxicity. A total of 38 patients with a median age of 76 years were enrolled. The majority of the patients were men (66%), had an Eastern Cooperative Oncology Group performance status of 1 (58%), stage IV disease (66%) and adenocarcinoma (74%). Of the 35 patients, 13 (34%) had tumors with EGFR mutations. The ORR was 26.3% (95% confidence interval: 12.1-40.5%) and the disease control rate was 47.4%. The median PFS was 3.7 months and the median OS was 17.3 months. The grade 3 adverse events observed included rash (13%), diarrhea (5%), interstitial pneumonitis (5%), anorexia (3%) and gastrointestinal bleeding (3%). Grade 4 or 5 adverse events were not observed. The median OS did not differ significantly between patients aged <75 years (14.9 months) and those aged ≥75 years (19.0 months; P=0.226). Therefore, erlotinib was found to be effective and well-tolerated in elderly patients with previously treated NSCLC.
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Affiliation(s)
- Masayoshi Miyawaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Katsuhiko Naoki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan.,Cancer Center, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Satoshi Yoda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Sohei Nakayama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Ryosuke Satomi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takashi Sato
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Shinnosuke Ikemura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Keiko Ohgino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kota Ishioka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Daisuke Arai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Ho Namkoong
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kengo Otsuka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masaki Miyazaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tetsuo Tani
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Aoi Kuroda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Makoto Nishino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hidefumi Koh
- Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Morio Nakamura
- Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takeshi Terashima
- Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Fumio Sakamaki
- Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Koichi Sayama
- Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kenzo Soejima
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.,Keio Lung Oncology Group, Keio University School of Medicine, Tokyo 160-8582, Japan
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Tateno H, Miseki Y, Sayama K. Photoelectrochemical dimethoxylation of furan via a bromide redox mediator using a BiVO4/WO3 photoanode. Chem Commun (Camb) 2017; 53:4378-4381. [DOI: 10.1039/c7cc01190c] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Photoelectrochemical dimethoxylation of furan with methanol using a BiVO4/WO3 photoanode and Br+/Br− as a mediator was demonstrated with low applied potential.
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Affiliation(s)
- H. Tateno
- Advanced Functional Materials Team, Research Center for Photovoltaics (RCPV)
- National Institute of Advanced Industrial Science and Technology (AIST)
- Tsukuba
- Japan
| | - Y. Miseki
- Advanced Functional Materials Team, Research Center for Photovoltaics (RCPV)
- National Institute of Advanced Industrial Science and Technology (AIST)
- Tsukuba
- Japan
| | - K. Sayama
- Advanced Functional Materials Team, Research Center for Photovoltaics (RCPV)
- National Institute of Advanced Industrial Science and Technology (AIST)
- Tsukuba
- Japan
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38
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Mori H, Murakami M, Utsunomiya R, Masuda K, Dai X, Tohyama M, Nakaoka H, Sayama K. 089 Suppressive effect of HMGB1 via poly (I:C) induced inflammation in keratinocyte. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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39
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Masaki K, Ishii M, Anraku M, Namkoong H, Miyakawa R, Nakajima T, Fukunaga K, Naoki K, Tasaka S, Soejima K, Sayama K, Sugita K, Iwata S, Cui L, Hanaki H, Hasegawa N, Betsuyaku T. Fatal Fulminant Pneumonia Caused by Methicillin-Sensitive Staphylococcus aureus Negative for Major High-Virulence Factors Following Influenza B Virus Infection. Am J Case Rep 2015; 16:454-8. [PMID: 26171835 PMCID: PMC4514331 DOI: 10.12659/ajcr.894022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Patient: Male, 32 Final Diagnosis: MSSA pneumonia Symptoms: Cough • dyspnea • fever Medication: Meropenem • levofloxacin • vancomycin • peramivir Clinical Procedure: Diagnosed based on CT images • sputum culture • PCR Specialty: Infectious Diseases
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Affiliation(s)
- Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masaki Anraku
- Division of General Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ho Namkoong
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ryo Miyakawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Nakajima
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Katsuhiko Naoki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Sadatomo Tasaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kenzo Soejima
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kayoko Sugita
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Iwata
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Longzhu Cui
- Research Center for Infections and Antimicrobials, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Hideaki Hanaki
- Research Center for Infections and Antimicrobials, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Naoki Hasegawa
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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40
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Tsukada J, Hasegawa I, Torikai H, Sayama K, Jinzaki M, Narimatsu Y. Interventional Therapeutic Strategy for Hemoptysis Originating from Infectious Pulmonary Artery Pseudoaneurysms. J Vasc Interv Radiol 2015; 26:1046-1051.e1. [DOI: 10.1016/j.jvir.2015.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 02/25/2015] [Accepted: 04/02/2015] [Indexed: 10/23/2022] Open
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41
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Matsusaka M, Kabata H, Fukunaga K, Suzuki Y, Masaki K, Mochimaru T, Sakamaki F, Oyamada Y, Inoue T, Oguma T, Sayama K, Koh H, Nakamura M, Umeda A, Ono J, Ohta S, Izuhara K, Asano K, Betsuyaku T. Phenotype of asthma related with high serum periostin levels. Allergol Int 2015; 64:175-80. [PMID: 25838094 DOI: 10.1016/j.alit.2014.07.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/14/2014] [Accepted: 11/22/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Asthma is a heterogeneous disease composed of various phenotypes. Periostin, a molecule inducible with interleukin (IL)-4 or IL-13 in bronchial epithelial cells, is a biomarker of "TH2-high" asthma. The objective of this study is to examine whether the serum periostin concentrations are correlated with the severity, specific phenotype(s), or comorbidity of asthma. METHODS Serum concentrations of periostin were measured in 190 Japanese asthmatic patients and 11 healthy controls. The protocol was registered under UMIN 000002980 in the clinical trial registry. RESULTS The serum concentrations of periostin were significantly higher (P = 0.014) in asthmatics [70.0 (54.0-93.5) ng/ml] than in healthy subjects [57.0 (39.0-63.0) ng/ml], though we found no correlation between serum periostin concentrations and treatment steps required to control asthma. To characterize "high-periostin" phenotype(s), the patients with asthma were divided among tertiles based on the serum concentrations of periostin. The high-periostin group was older at onset of asthma (P = 0.04), had a higher prevalence of aspirin intolerance (P = 0.04) or concomitant nasal disorders (P = 0.03-0.001), higher peripheral eosinophil counts (P < 0.001), and lower pulmonary function (P = 0.02-0.07). The serum concentrations of periostin were particularly high in asthmatic patients complicated by chronic rhinosinusitis with nasal polyps and olfactory dysfunction. In contrast, neither atopic status, control status of asthma, nor quality of life were related with the "high-periostin" phenotype. CONCLUSION Elevated periostin concentrations in serum were correlated with a specific phenotype of eosinophilic asthma, late-onset and often complicated by obstructive pulmonary dysfunction and nasal disorders.
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Affiliation(s)
- Masako Matsusaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Hiroki Kabata
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan; Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Takao Mochimaru
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
| | - Fumio Sakamaki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University Hachioji Hospital, Tokyo, Japan; Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | | | - Takashi Inoue
- Department of Medicine, Sanokousei General Hospital, Tochigi, Japan
| | - Tsuyoshi Oguma
- Kawasaki Municipal Hospital, Kanagawa, Japan; Division of Pulmonary Medicine, Department of Medicine, Tokai University, School of Medicine, Kanagawa, Japan
| | | | - Hidefumi Koh
- Department of Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan; Department of Medicine, Tachikawa Kyosai Hospital, Tokyo, Japan
| | - Morio Nakamura
- Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan; Department of Medicine, Eiju General Hospital, Tokyo, Japan
| | - Akira Umeda
- Department of Medicine, Shioya Hospital, International University of Health and Welfare, Tochigi, Japan
| | - Junya Ono
- Shino-Test Corporation, Tokyo, Japan
| | - Shoichiro Ohta
- Department of Laboratory Medicine, Saga Medical School, Saga, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan; Division of Pulmonary Medicine, Department of Medicine, Tokai University, School of Medicine, Kanagawa, Japan.
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan
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Miyawaki S, Kohara K, Kido T, Tabara Y, Igase M, Miki T, Sayama K. Facial pigmentation as a biomarker of carotid atherosclerosis in middle-aged to elderly healthy Japanese subjects. Skin Res Technol 2015; 22:20-4. [DOI: 10.1111/srt.12223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2015] [Indexed: 01/27/2023]
Affiliation(s)
- S. Miyawaki
- Department of Dermatology; Ehime University Graduate School of Medicine; Ehime Japan
| | - K. Kohara
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - T. Kido
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - Y. Tabara
- Center for Genomic Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - M. Igase
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - T. Miki
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - K. Sayama
- Department of Dermatology; Ehime University Graduate School of Medicine; Ehime Japan
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43
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Abstract
PbCrO4 which possesses attractive optical absorption properties (BG: 2.3 eV) and electronic structure showed photocatalyzed water oxidation activity in the presence of IO3− ions.
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Affiliation(s)
- Y. Miseki
- Energy Technology Research Institute
- National Institute of Advanced Industrial Science and Technology (AIST)
- Tsukuba
- Japan
| | - O. Kitao
- Energy Technology Research Institute
- National Institute of Advanced Industrial Science and Technology (AIST)
- Tsukuba
- Japan
| | - K. Sayama
- Energy Technology Research Institute
- National Institute of Advanced Industrial Science and Technology (AIST)
- Tsukuba
- Japan
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44
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Tanaka K, Kamiishi N, Miyata J, Kabata H, Masaki K, Ogura-Tomomatsu H, Tomomatsu K, Suzuki Y, Fukunaga K, Sayama K, Betsuyaku T, Asano K. Determinants of Long-Term Persistence with Tiotropium Bromide for Chronic Obstructive Pulmonary Disease. COPD 2014; 12:233-9. [DOI: 10.3109/15412555.2014.933795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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45
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Masaki K, Suzuki Y, Kagawa S, Kodama M, Kabata H, Miyata J, Tanaka K, Fukunaga K, Sayama K, Oguma T, Kimura T, Amagai M, Betsuyaku T, Asano K. Dual role of interleukin-23 in epicutaneously-sensitized asthma in mice. Allergol Int 2014; 63 Suppl 1:13-22. [PMID: 24809371 DOI: 10.2332/allergolint.13-oa-0632] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 01/29/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Interleukin (IL)-23/Th17 axis plays an important role in the pathophysiology of asthma and eczema, however, there are some conflicting data about the effects of this system on allergic airway inflammation. In the present study, we aim to dissect the spatiotemporal differences in the roles of IL-23 in an epicutaneously-sensitized asthma model of mice. METHODS C57BL/6 mice were sensitized to ovalbumin (OVA) by patch application on the skin, followed by airway exposure to aerosolized OVA. During sensitization and/or challenge phase, either a specific neutralizing antibody (Ab) against IL-23 or control IgG was injected intraperitoneally. On days 1 and 8 after the final OVA exposure, airway inflammation and responsiveness to methacholine, immunoglobulin levels in serum, and cytokine release from splenocytes were evaluated. Skin Il23a mRNA levels were evaluated with quantitative RT-PCR. RESULTS Patch application time-dependently increased the expression of Il23a mRNA expression in the skin. Treatment with the anti-IL-23 Ab during sensitization phase alone significantly reduced the number of eosinophils in bronchoalveolar lavage fluids and peribronchial spaces after allergen challenge compared with treatment with control IgG. Anti-IL-23 Ab also reduced serum levels of OVA-specific IgG1. In contrast, treatment with the anti-IL-23 Ab during the challenge phase alone rather exacerbated airway hyperresponsiveness to methacholine with little effects on airway eosinophilia or serum IgG1 levels. CONCLUSIONS IL-23 expressed in the skin during the sensitization phase plays an essential role in the development of allergic phenotypes, whereas IL-23 in the airways during the challenge phase suppresses airway hyperresponsiveness.
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Affiliation(s)
- Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan; MSD Endowed Program for Allergy Research, Keio University School of Medicine, Tokyo, Japan
| | - Shizuko Kagawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan; MSD Endowed Program for Allergy Research, Keio University School of Medicine, Tokyo, Japan
| | - Motohiro Kodama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kabata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun Miyata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kyuto Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan; Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tokuhiro Kimura
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan; Present address: Department of Pathology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Masayuki Amagai
- MSD Endowed Program for Allergy Research, Keio University School of Medicine, Tokyo, Japan; Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan; MSD Endowed Program for Allergy Research, Keio University School of Medicine, Tokyo, Japan; Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Miyazaki M, Nakamura H, Chubachi S, Sasaki M, Haraguchi M, Yoshida S, Tsuduki K, Shirahata T, Takahashi S, Minematsu N, Koh H, Nakamura M, Sakamaki F, Terashima T, Sayama K, Jones PW, Asano K, Betsuyaku T. Analysis of comorbid factors that increase the COPD assessment test scores. Respir Res 2014; 15:13. [PMID: 24502760 PMCID: PMC3922022 DOI: 10.1186/1465-9921-15-13] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 02/03/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is a concise health status measure for COPD. COPD patients have a variety of comorbidities, but little is known about their impact on quality of life. This study was designed to investigate comorbid factors that may contribute to high CAT scores. METHODS An observational study at Keio University and affiliated hospitals enrolled 336 COPD patients and 67 non-COPD subjects. Health status was assessed by the CAT, the St. Georges Respiratory Questionnaire (SGRQ), and all components of the Medical Outcomes Study Short-Form 36-Item (SF-36) version 2, which is a generic measure of health. Comorbidities were identified based on patients' reports, physicians' records, and questionnaires, including the Frequency Scale for the Symptoms of Gastro-esophageal reflux disease (GERD) and the Hospital Anxiety and Depression Scale. Dual X-ray absorptiometry measurements of bone mineral density were performed. RESULTS The CAT showed moderate-good correlations with the SGRQ and all components of the SF-36. The presence of GERD, depression, arrhythmia, and anxiety was significantly associated with a high CAT score in the COPD patients. CONCLUSIONS Symptomatic COPD patients have a high prevalence of comorbidities. A high CAT score should alert the clinician to a higher likelihood of certain comorbidities such as GERD and depression, because these diseases may co-exist unrecognized. TRIAL REGISTRATION Clinical trial registered with UMIN (UMIN000003470).
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Affiliation(s)
- Masaki Miyazaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hidetoshi Nakamura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Mamoru Sasaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Mizuha Haraguchi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shuichi Yoshida
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Keishi Tsuduki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Toru Shirahata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Saeko Takahashi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Naoto Minematsu
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | | | | | | | - Takeshi Terashima
- Department of Respiratory Medicine, Tokyo Dental College, Chiba, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Paul W Jones
- Division of Clinical Science, St. George’s University of London, London, UK
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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47
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Masaki K, Naoki K, Soejima K, Sayama K, Kamiishi N, Tanaka K, Ishioka K, Sasaki A, Hayashi Y, Funakoshi T, Susa M, Morioka H, Tasaka S, Asano K, Betsuyaku T. Clear cell sarcoma originating in the anterior mediastinum. Int Cancer Conf J 2013. [DOI: 10.1007/s13691-013-0093-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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48
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Miyata J, Fukunaga K, Iwamoto R, Isobe Y, Niimi K, Takamiya R, Takihara T, Tomomatsu K, Suzuki Y, Oguma T, Sayama K, Arai H, Betsuyaku T, Arita M, Asano K. Dysregulated synthesis of protectin D1 in eosinophils from patients with severe asthma. J Allergy Clin Immunol 2013; 131:353-60.e1-2. [DOI: 10.1016/j.jaci.2012.07.048] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 06/29/2012] [Accepted: 07/27/2012] [Indexed: 01/06/2023]
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Kamata H, Koh H, Okubo Y, Kunimoto H, Chiyotani A, Sayama K, Hasegawa N, Mukai M. Antineutrophil cytoplasmic antibody-associated vasculitis involving diffuse alveolar hemorrhage, rapidly progressive glomerulonephritis and hypereosinophilia. Intern Med 2013; 52:2253-7. [PMID: 24088762 DOI: 10.2169/internalmedicine.52.0481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The classification of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has limitations because the condition includes disorders with similar general clinical features, similar characteristics of lung and renal involvement and a positive ANCA serology. A 40-year-old woman was admitted to our hospital for hemoptysis and dyspnea. She had no history of bronchial asthma. Laboratory examinations revealed hypereosinophilia, positive anti-myeloperoxidase antibodies, hematuria and proteinuria. The patient was ultimately diagnosed with AAV associated with diffuse alveolar hemorrhage, rapidly progressive glomerulonephritis and hypereosinophilia without bronchial asthma. Obtaining a definitive diagnosis of ANCA vasculitis can be very difficult, and the characteristics of this case were not compatible with the findings of typical AVV. We herein report a rare case of AVV.
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Affiliation(s)
- Hirofumi Kamata
- Division of Pulmonary Medicine, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Japan
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Miyata J, Tasaka S, Miyazaki M, Yoshida S, Naoki K, Sayama K, Asano K, Fujiwara H, Ohkusu K, Hasegawa N, Betsuyaku T. Bacillus cereus necrotizing pneumonia in a patient with nephrotic syndrome. Intern Med 2013; 52:101-4. [PMID: 23291682 DOI: 10.2169/internalmedicine.52.7282] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Bacillus cereus (B. cereus) is a Gram-positive rod that is widely distributed in the environment and can be a cause of food poisoning. We herein present a case of B. cereus necrotizing pneumonia in a patient with nephrotic syndrome under corticosteroid treatment after developing transient gastroenteritis symptoms. B. cereus was isolated from bronchial lavage fluid and transbronchial biopsy specimens. A multiplex polymerase chain reaction analysis of the toxin genes revealed a strain possessing enterotoxicity. The patient recovered after one week of intravenous meropenem followed by a combination of oral moxifloxacin and clindamycin. B. cereus is a pathogen that causes necrotizing pneumonia in immunocompromised hosts.
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Affiliation(s)
- Jun Miyata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
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