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Kamata H, Takamatsu K, Fukunaga K, Chubachi S, Nakagawara K, Namkoong H, Terai H, Tanaka K, Sato S, Hagiwara E, Takei R, Kondoh Y, Takazono T, Hashimoto M, Tasaka S, Ohrui T, Tanino Y, Mineshita M, Komase Y, Miyazaki K, Nishikawa M, Ando A, Kita H, Ichihara E, Ohshimo S, Murata Y, Ishida M, Kobayashi S, Uchida T, Tateno H, Ikari J, Terashima T, Kozu Y, Tateishi T, Shinkai M, Sagara H, To Y, Ito Y, Yamamoto M, Yamamoto Y, Kita T, Ito Y, Tomii K, Fujita Y, Funaki Y, Yatera K, Yamasue M, Komiya K, Kozawa S, Manabe H, Hozumi H, Horiguchi T, Kitajima T, Nakano Y, Nagaoka T, Hojo M, Ebihara A, Kobayashi M, Takayama K, Jinta T, Sawai T, Fukuda Y, Kaneko T, Chin K, Ogura T, Mukae H, Ishii M, Yokoyama A. Pulmonary function and chest CT abnormalities 3 months after discharge from COVID-19, 2020-2021: A nation-wide multicenter prospective cohort study from the Japanese respiratory society. Respir Investig 2024; 62:572-579. [PMID: 38669898 DOI: 10.1016/j.resinv.2024.02.009] [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: 09/21/2023] [Revised: 02/07/2024] [Accepted: 02/17/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND No comprehensive analysis of the pulmonary sequelae of coronavirus disease 2019 (COVID-19) in Japan based on respiratory function tests and chest computed tomography (CT) has been reported. We evaluated post-COVID-19 conditions, especially focusing on pulmonary sequelae assessed by pulmonary function tests and chest CT. METHODS For this prospective cohort study, we enrolled 1069 patients who presented pneumonia at the time of admission in 55 hospitals from February 2020 to September 2021. Disease severity was classified as moderateⅠ, moderate II, and severe, defined primarily according to the degree of respiratory failure. The data on post-COVID-19 conditions over 12 months, pulmonary function, and chest CT findings at 3 months were evaluated in this study. Additionally, the impact of COVID-19 severity on pulmonary sequelae, such as impaired diffusion capacity, restrictive pattern, and CT abnormalities, was also evaluated. RESULTS The most frequently reported post-COVID-19 conditions at 3 months after COVID-19 were muscle weakness, dyspnea, and fatigue (48.4%, 29.0%, and 24.7%, respectively). The frequency of symptoms gradually decreased over subsequent months. In pulmonary function tests at 3 months, the incidence of impaired diffusion capacity and restrictive pattern increased depending on disease severity. There also were differences in the presence of chest CT abnormalities at the 3 months, which was markedly correlated with the severity. CONCLUSION We reported a comprehensive analysis of post-COVID-19 condition, pulmonary function, and chest CT abnormalities in Japanese patients with COVID-19. The findings of this study will serve as valuable reference data for future post-COVID-19 condition research in Japan.
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Affiliation(s)
- Hirofumi Kamata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazufumi Takamatsu
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Koichi Fukunaga
- 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
| | - Kensuke Nakagawara
- 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, 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
| | - Katsushi Tanaka
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Susumu Sato
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoinkawaharacho, Sakyo-ku, 606-8507, Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
| | - Reoto Takei
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwakecho, Seto, Aichi, 489-8642, Japan
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwakecho, Seto, Aichi, 489-8642, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Midori Hashimoto
- Department of Respiratory Medicine, NTT-East Corporation Sapporo Medical Center, South 1, West 15, Chuo-ku, Sapporo, 060-0061, Japan
| | - Sadatomo Tasaka
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan
| | - Takashi Ohrui
- Division of Respiratory Medicine, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Masamichi Mineshita
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa, 241-0811, Japan
| | - Kazuhito Miyazaki
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Masanori Nishikawa
- Department of Respiratory Medicine, Fujisawa City Hospital, 2-6-1 Fujisawa, Kanagawa, 251-8550, Japan
| | - Akira Ando
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Hideo Kita
- Department of Respiratory Medicine, Takatsuki Red Cross Hospital, 1-1-1 Abuno, Takatsuki, Osaka, 569-1045, Japan
| | - Eiki Ichihara
- Center for Clinical Oncology, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan
| | - Shinichiro Ohshimo
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-0037, Japan
| | - Yoriyuki Murata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Masayuki Ishida
- Department of Respiratory Medicine, Chikamori Hospital, 1-1-6 Okawasuji, Kochi, 780-8522, Japan
| | - Seiichi Kobayashi
- Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, 71 Nishimichishita, Hebita, Ishinomaki, Miyagi, 986-8522, Japan
| | - Takahiro Uchida
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Irumagun Moroyamamachi, Saitama, 350-0495, Japan
| | - Hiroki Tateno
- Department of Pulmonary Medicine, Saitama City Hospital, 2460, Oazamimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Jun Ikari
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Takeshi Terashima
- Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba, 272-0824, Japan
| | - Yutaka Kozu
- Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Masaharu Shinkai
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Hironori Sagara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Yasuo To
- Department of Pulmonary Medicine, International University of Health and Welfare School of Medicine, 852 Hatakeda, Narita, Chiba, 286-0124, Japan
| | - Yoko Ito
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Masaki Yamamoto
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Hospital, 2630 Sugitani, Toyama, 930-0152, Japan
| | - Toshiyuki Kita
- The Department of Respiratory Medicine, NHO Kanazawa Medical Center, 1-1 Shimoishibikimachi, Kanazawa, Ishikawa, 920-8650, Japan
| | - Yutaka Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Mizuhochokawasumi, Mizuho-ku, Nagoya, 467-8602, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Yukio Fujita
- Department of Respiratory Medicine, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan
| | - Yoshihiro Funaki
- Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807- 8556, Japan
| | - Mari Yamasue
- Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Hasamamachiidaigaoka, Yufu, Oita, 879-5503, Japan
| | - Kosaku Komiya
- Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Hasamamachiidaigaoka, Yufu, Oita, 879-5503, Japan
| | - Satoko Kozawa
- Center for Asbestos-Related Diseases, Yokohama Rosai Hospital, 3211, Kozukuecho, Kohoku-ku, Yokohama, Kanagawa, 222-0036, Japan
| | - Hideaki Manabe
- Department of Respiratory Medicine, Sagamihara Kyodo Hospital, 4-3-1 Hashimotodai, Midori-ku, Sagamihara, Kanagawa, 252-5188, Japan
| | - Hironao Hozumi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Tomoya Horiguchi
- Department of Respiratory Medicine, Fujita Health University School of Medicine, 1-98 Kutsukakechodengakugakubo, Toyoake, Aichi, 470-1192, Japan
| | - Takamasa Kitajima
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ogimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Yasushi Nakano
- Department of Respiratory Medicine, Kawasaki Municipal Ida Hospital, 2-27-1 Ida, Nakahara-ku, Kawasaki, Kanagawa, 211-0035, Japan
| | - Tetsutaro Nagaoka
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Akinori Ebihara
- Department of Respiratory Medicine, Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan
| | - Masayoshi Kobayashi
- Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo, 130-8575, Japan
| | - Koji Takayama
- Department of Respiratory Medicine, Musashino Red Cross Hospital, 1-26-1 Kyonancho, Musashino, Tokyo, 180-0023, Japan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Toyomitsu Sawai
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchimachi, Nagasaki, 850-0842, Japan
| | - Yuichi Fukuda
- Department of Respiratory Medicine, Sasebo City General Hospital, 9-3 Hirasecho, Sasebo, Nagasaki, 857-8511, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kazuo Chin
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Makoto Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Akihito Yokoyama
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
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Nakagama S, Nakagama Y, Komase Y, Kudo M, Imai T, Tshibangu-Kabamba E, Nitahara Y, Kaku N, Kido Y. Age-adjusted impact of prior COVID-19 on SARS-CoV-2 mRNA vaccine response. Front Immunol 2023; 14:1087473. [PMID: 36742291 PMCID: PMC9892832 DOI: 10.3389/fimmu.2023.1087473] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023] Open
Abstract
More people with a history of prior infection are receiving SARS-CoV-2 vaccines. Understanding the level of protection granted by 'hybrid immunity', the combined response of infection- and vaccine-induced immunity, may impact vaccination strategies through tailored dosing. A total of 36 infected ('prior infection') and 33 SARS-CoV-2 'naïve' individuals participated. Participants provided sera six months after completing a round of BNT162b2 vaccination, to be processed for anti-spike antibody measurements and the receptor binding domain-ACE2 binding inhibition assays. The relationships between antibody titer, groups and age were explored. Anti-spike antibody titers at 6 months post-vaccination were significantly higher, reaching 13- to 17-fold, in the 'prior infection' group. Semi-log regression models showed that participants with 'prior infection' demonstrated higher antibody titer compared with the 'naïve' even after adjusting for age. The enhancement in antibody titer attributable to positive infection history increased from 8.9- to 9.4- fold at age 30 to 19- to 32-fold at age 60. Sera from the 'prior infection' group showed higher inhibition capacity against all six analyzed strains, including the Omicron variant. Prior COVID-19 led to establishing enhanced humoral immunity at 6 months after vaccination. Antibody fold-difference attributed to positive COVID-19 history increased with age, possibly because older individuals are prone to symptomatic infection accompanied by potentiated immune responses. While still pending any modifications of dosing recommendations (i.e. reduced doses for individuals with prior infection), our observation adds to the series of real-world data demonstrating the enhanced and more durable immune response evoked by booster vaccinations following prior infection.
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Affiliation(s)
- Sachie Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yu Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University, Yokohama Seibu Hospital, Yokohama, Japan
| | - Masaharu Kudo
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Takumi Imai
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Evariste Tshibangu-Kabamba
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yuko Nitahara
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Natsuko Kaku
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yasutoshi Kido
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Tsuburai T, Ueno J, Komase Y, Oyama B, Muraoka H, Shinozaki Y, Nishiyama K, Tanaka S, Nishi Y, Numata Y, Hida N, Inoue T. [THE INFLUENCE OF SENSITIZATION TO ASPERGILLUS AND ALTERNARIA IN ADULT BRONCHIAL ASTHMATICS MANAGED VIA YOKOHAMA CITY SEIBU HOSPITAL'S COORDINATED-CARE SYSTEM]. Arerugi 2023; 72:471-478. [PMID: 37460289 DOI: 10.15036/arerugi.72.471] [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] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND The sensitizations to various fungal allergens influence to exacerbation of bronchial asthma. Aspergillus (Asp) and Alternaria (Alt) were one of important fungal allergens for asthma. AIM AND METHODS To investigate the influence of sensitization to Asp or Alt in adult asthmatics managed via our asthma coordinated-care system, we recruited 119 patients (91 women) who were measured IgE for Asp (IgE-Asp) and IgE for Alt (IgE-Alt) at three times during two years,Results: In 119 patients, we detected positive IgE for Asp (IgE-Asp(+)) in 19 patients and positive IgE for Alt (IgE-Alt(+)) in 11 patients. 9 patients showed positive both of them. During two years, 7 patients became positive IgE-Asp and 3 cases became negative. And also, 3 cases became positive IgE-Alt and 3 cases became negative. At baseline, serum IgE, IgG4, and inhaled corticosteroid (ICS) dose of the group with IgE-Asp (+) or IgE-Alt (+), were significant higher than those of negative group. Among three groups, there was no significant change about other parameters at baseline, exacerbation frequency, or the change of parameters during two years. CONCLUSION The sensitizations to Asp or Alt were present in 19 asthmatics (16%) managed via our coordinate-care system. During 2 years, there was not significant change at exacerbation frequency among three groups, but the levels of IgE, IgG4, or ICS dose were significantly higher at IgE-Asp (+) or IgE-Alt (+) group than negative group. In the asthma management, it was considered necessary to pay attention to the sensitization to Asp or Alt.
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Affiliation(s)
- Takahiro Tsuburai
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Junko Ueno
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Baku Oyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Hiromi Muraoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yusuke Shinozaki
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Kazuhiro Nishiyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Satoshi Tanaka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yoshihiro Nishi
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yu Numata
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Naoya Hida
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Takeo Inoue
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
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Tsuburai T, Usuba AT, Komase Y, Oyama B, Muraoka H, Shinozaki Y, Nishiyama K, Ueno J, Nishi Y, Numata Y, Tanaka S, Yamaguchi H, Hida N, Inoue T. [THE RELATIONSHIP AMONG BRONCHIAL HYPERSENSITIVITY, BRONCHIAL HYPER REACTIVITY, AND BRONCHIAL HYPERRESPONSIVENESS IN ASTOGRAPH]. Arerugi 2023; 72:1120-1128. [PMID: 37967958 DOI: 10.15036/arerugi.72.1120] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND Bronchial hyperresponsiveness testing is useful for diagnosing and predicting the risk of bronchial asthma attacks. The Astograph is a tidal breathing method often used in as bronchial provocation testing in Japan. The minimum methachorine dose (Dmin) indicates bronchial sensitivity and is used mainly as an index of bronchial hyperresponsiveness. However, Dmin does not measured hyperresponsiveness, it cannot be compared directly with PC20 in standard methods using FEV1. METHODS We investigated the relationship among sensitivity, reactivity, and hyperresponsiveness with the Astograph. We recruited 142 patients with confirmed or suspected bronchial asthma from outpatient clinic at St. Marianna University School of Medicine, Yokohama City Seibu Hospital. We calculated Dmin, SGrs/Grscont, PD35Grs, and PD15Grs compared them as bronchial hyperresponsiveness indices. RESULTS Subjects had suspected asthma (n=103), or required assessment of asthma remission (n=39). There were significant relationships between logDmin and logPD35Grs (r=0.838, p<0.001), and between parameters and SGrs/Grscont (log PD35Grs r=-0.504, p<0.001, strong, logDmin: r=-0.191, p=0.023, weaker). Among subjects positive for hypersensitivity, (Dmin<10), 38 (36.5%) showed negative hyperresponsiveness (PD35Grs>25). PD15Grs was a strongly and significantly correlated with Dmin and PD35Grs. The ROC curve to detect PD35Grs<25, showed that the cutoff of PD15Grs was 10.7 (AUC 0.983, sensitivity 0.984, specificity 0.905). CONCLUSION In Astograph, evaluation of bronchial hyperresponsiveness, we focused on relationship differences between sensitivity and reactivity, and hyperresponsiveness. We revealed the usefulness of the PD15Grs evaluation method.
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Affiliation(s)
- Takahiro Tsuburai
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Ayano Tsukune Usuba
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Baku Oyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Hiromi Muraoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yusuke Shinozaki
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Kazuhiro Nishiyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Junko Ueno
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yoshihiro Nishi
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yu Numata
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Satoshi Tanaka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Hiromichi Yamaguchi
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Yamaguchi Respiratory and Dermatology Clinic
| | - Naoya Hida
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Takeo Inoue
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
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Nakagama Y, Candray K, Kaku N, Komase Y, Rodriguez-Funes MV, Dominguez R, Tsuchida T, Kunishima H, Nagai E, Adachi E, Ngoyi DM, Yamasue M, Komiya K, Hiramatsu K, Uemura N, Sugiura Y, Yasugi M, Yamagishi Y, Mikamo H, Shiraishi S, Izumo T, Nakagama S, Watanabe C, Nitahara Y, Tshibangu-Kabamba E, Kakeya H, Kido Y. Antibody avidity maturation, following recovery from infection or the booster vaccination, grants breadth in SARS-CoV-2 neutralizing capacity. J Infect Dis 2022; 227:780-787. [PMID: 36546706 PMCID: PMC10044078 DOI: 10.1093/infdis/jiac492] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/09/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
Cross-neutralizing capacity of antibodies against SARS-CoV-2 variants is important in mitigating (re-)exposures. Role of antibody maturation, the process whereby selection of higher affinity antibodies augments host immunity, to determine SARS-CoV-2 neutralizing capacity was investigated.
Methods
Sera from SARS-CoV-2 convalescents at 2-, 6-, or 10-months post-recovery, and BNT162b2 vaccine recipients at 3- or 25-weeks post-vaccination, were analyzed. Anti-spike IgG avidity was measured on urea-treated ELISAs. Neutralizing capacity was assessed by surrogate neutralization assays. Fold change between variant and wild-type neutralization inferred the breadth of neutralizing capacity.
Results
Compared with early-convalescence, avidity indices of late-convalescent sera were significantly higher (median 37.7 (interquartile range 28.4–45.1) vs. 64.9 (57.5–71.5), p < 0.0001). Urea-resistant, high-avidity IgG best predicted neutralizing capacity (Spearman’s r = 0.49 vs. 0.67 (wild-type); 0.18–0.52 vs. 0.48–0.83 (variants)). Higher-avidity convalescent sera better cross-neutralized SARS-CoV-2 variants (p < 0.001 (Alpha); p < 0.01 (Delta and Omicron)). Vaccinees only experienced meaningful avidity maturation following the booster dose, exhibiting rather limited cross-neutralizing capacity at week-25.
Conclusions
Avidity maturation was progressive beyond acute recovery from infection, or became apparent after the booster vaccine dose, granting broader anti-SARS-CoV-2 neutralizing capacity. Understanding the maturation kinetics of the two building blocks of anti-SARS-CoV-2 humoral immunity is crucial.
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Affiliation(s)
- Yu Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Katherine Candray
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Centro Nacional de Investigaciones Científicas de El Salvador (CICES) , San Salvador, El Salvador
| | - Natsuko Kaku
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University, Yokohama Seibu Hospital , Yokohama , Japan
| | | | - Rhina Dominguez
- El Salvador National Institute of Health , San Salvador, El Salvador
| | - Tomoya Tsuchida
- Division of General Internal Medicine, St. Marianna University School of Medicine , Kawasaki , Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine , Kawasaki , Japan
| | - Etsuko Nagai
- Department of Infectious Diseases and Applied Immunology, Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Eisuke Adachi
- Department of Infectious Diseases and Applied Immunology, Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Dieudonné Mumba Ngoyi
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Mari Yamasue
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine , Oita , Japan
| | - Kosaku Komiya
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine , Oita , Japan
| | - Kazufumi Hiramatsu
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine , Oita , Japan
| | - Naoto Uemura
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine , Oita , Japan
| | - Yuki Sugiura
- Center for Cancer Immunotherapy and Immunobiology, Kyoto University Graduate School of Medicine , Kyoto , Japan
| | - Mayo Yasugi
- Graduate School of Veterinary Science, Osaka Metropolitan University , Osaka , Japan
- Asian Health Science Research Institute, Osaka Metropolitan University , Osaka , Japan
- Osaka International Research Center for Infectious Diseases, Osaka Metropolitan University , Osaka , Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University , Aichi , Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University , Aichi , Japan
| | - Satoshi Shiraishi
- Department of Respiratory Medicine, Osaka City Juso Hospital , Osaka , Japan
| | - Takehiro Izumo
- Department of Respiratory Medicine, Japanese Red Cross Medical Center , Tokyo , Japan
| | - Sachie Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Chihiro Watanabe
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Yuko Nitahara
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Evariste Tshibangu-Kabamba
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Hiroshi Kakeya
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Yasutoshi Kido
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
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Wang QS, Edahiro R, Namkoong H, Hasegawa T, Shirai Y, Sonehara K, Tanaka H, Lee H, Saiki R, Hyugaji T, Shimizu E, Katayama K, Kanai M, Naito T, Sasa N, Yamamoto K, Kato Y, Morita T, Takahashi K, Harada N, Naito T, Hiki M, Matsushita Y, Takagi H, Ichikawa M, Nakamura A, Harada S, Sandhu Y, Kabata H, Masaki K, Kamata H, Ikemura S, Chubachi S, Okamori S, Terai H, Morita A, Asakura T, Sasaki J, Morisaki H, Uwamino Y, Nanki K, Uchida S, Uno S, Nishimura T, Ishiguro T, Isono T, Shibata S, Matsui Y, Hosoda C, Takano K, Nishida T, Kobayashi Y, Takaku Y, Takayanagi N, Ueda S, Tada A, Miyawaki M, Yamamoto M, Yoshida E, Hayashi R, Nagasaka T, Arai S, Kaneko Y, Sasaki K, Tagaya E, Kawana M, Arimura K, Takahashi K, Anzai T, Ito S, Endo A, Uchimura Y, Miyazaki Y, Honda T, Tateishi T, Tohda S, Ichimura N, Sonobe K, Sassa CT, Nakajima J, Nakano Y, Nakajima Y, Anan R, Arai R, Kurihara Y, Harada Y, Nishio K, Ueda T, Azuma M, Saito R, Sado T, Miyazaki Y, Sato R, Haruta Y, Nagasaki T, Yasui Y, Hasegawa Y, Mutoh Y, Kimura T, Sato T, Takei R, Hagimoto S, Noguchi Y, Yamano Y, Sasano H, Ota S, Nakamori Y, Yoshiya K, Saito F, Yoshihara T, Wada D, Iwamura H, Kanayama S, Maruyama S, Yoshiyama T, Ohta K, Kokuto H, Ogata H, Tanaka Y, Arakawa K, Shimoda M, Osawa T, Tateno H, Hase I, Yoshida S, Suzuki S, Kawada M, Horinouchi H, Saito F, Mitamura K, Hagihara M, Ochi J, Uchida T, Baba R, Arai D, Ogura T, Takahashi H, Hagiwara S, Nagao G, Konishi S, Nakachi I, Murakami K, Yamada M, Sugiura H, Sano H, Matsumoto S, Kimura N, Ono Y, Baba H, Suzuki Y, Nakayama S, Masuzawa K, Namba S, Shiroyama T, Noda Y, Niitsu T, Adachi Y, Enomoto T, Amiya S, Hara R, Yamaguchi Y, Murakami T, Kuge T, Matsumoto K, Yamamoto Y, Yamamoto M, Yoneda M, Tomono K, Kato K, Hirata H, Takeda Y, Koh H, Manabe T, Funatsu Y, Ito F, Fukui T, Shinozuka K, Kohashi S, Miyazaki M, Shoko T, Kojima M, Adachi T, Ishikawa M, Takahashi K, Inoue T, Hirano T, Kobayashi K, Takaoka H, Watanabe K, Miyazawa N, Kimura Y, Sado R, Sugimoto H, Kamiya A, Kuwahara N, Fujiwara A, Matsunaga T, Sato Y, Okada T, Hirai Y, Kawashima H, Narita A, Niwa K, Sekikawa Y, Nishi K, Nishitsuji M, Tani M, Suzuki J, Nakatsumi H, Ogura T, Kitamura H, Hagiwara E, Murohashi K, Okabayashi H, Mochimaru T, Nukaga S, Satomi R, Oyamada Y, Mori N, Baba T, Fukui Y, Odate M, Mashimo S, Makino Y, Yagi K, Hashiguchi M, Kagyo J, Shiomi T, Fuke S, Saito H, Tsuchida T, Fujitani S, Takita M, Morikawa D, Yoshida T, Izumo T, Inomata M, Kuse N, Awano N, Tone M, Ito A, Nakamura Y, Hoshino K, Maruyama J, Ishikura H, Takata T, Odani T, Amishima M, Hattori T, Shichinohe Y, Kagaya T, Kita T, Ohta K, Sakagami S, Koshida K, Hayashi K, Shimizu T, Kozu Y, Hiranuma H, Gon Y, Izumi N, Nagata K, Ueda K, Taki R, Hanada S, Kawamura K, Ichikado K, Nishiyama K, Muranaka H, Nakamura K, Hashimoto N, Wakahara K, Koji S, Omote N, Ando A, Kodama N, Kaneyama Y, Maeda S, Kuraki T, Matsumoto T, Yokote K, Nakada TA, Abe R, Oshima T, Shimada T, Harada M, Takahashi T, Ono H, Sakurai T, Shibusawa T, Kimizuka Y, Kawana A, Sano T, Watanabe C, Suematsu R, Sageshima H, Yoshifuji A, Ito K, Takahashi S, Ishioka K, Nakamura M, Masuda M, Wakabayashi A, Watanabe H, Ueda S, Nishikawa M, Chihara Y, Takeuchi M, Onoi K, Shinozuka J, Sueyoshi A, Nagasaki Y, Okamoto M, Ishihara S, Shimo M, Tokunaga Y, Kusaka Y, Ohba T, Isogai S, Ogawa A, Inoue T, Fukuyama S, Eriguchi Y, Yonekawa A, Kan-o K, Matsumoto K, Kanaoka K, Ihara S, Komuta K, Inoue Y, Chiba S, Yamagata K, Hiramatsu Y, Kai H, Asano K, Oguma T, Ito Y, Hashimoto S, Yamasaki M, Kasamatsu Y, Komase Y, Hida N, Tsuburai T, Oyama B, Takada M, Kanda H, Kitagawa Y, Fukuta T, Miyake T, Yoshida S, Ogura S, Abe S, Kono Y, Togashi Y, Takoi H, Kikuchi R, Ogawa S, Ogata T, Ishihara S, Kanehiro A, Ozaki S, Fuchimoto Y, Wada S, Fujimoto N, Nishiyama K, Terashima M, Beppu S, Yoshida K, Narumoto O, Nagai H, Ooshima N, Motegi M, Umeda A, Miyagawa K, Shimada H, Endo M, Ohira Y, Watanabe M, Inoue S, Igarashi A, Sato M, Sagara H, Tanaka A, Ohta S, Kimura T, Shibata Y, Tanino Y, Nikaido T, Minemura H, Sato Y, Yamada Y, Hashino T, Shinoki M, Iwagoe H, Takahashi H, Fujii K, Kishi H, Kanai M, Imamura T, Yamashita T, Yatomi M, Maeno T, Hayashi S, Takahashi M, Kuramochi M, Kamimaki I, Tominaga Y, Ishii T, Utsugi M, Ono A, Tanaka T, Kashiwada T, Fujita K, Saito Y, Seike M, Watanabe H, Matsuse H, Kodaka N, Nakano C, Oshio T, Hirouchi T, Makino S, Egi M, Omae Y, Nannya Y, Ueno T, Takano T, Katayama K, Ai M, Kumanogoh A, Sato T, Hasegawa N, Tokunaga K, Ishii M, Koike R, Kitagawa Y, Kimura A, Imoto S, Miyano S, Ogawa S, Kanai T, Fukunaga K, Okada Y. The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force. Nat Commun 2022; 13:4830. [PMID: 35995775 PMCID: PMC9395416 DOI: 10.1038/s41467-022-32276-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 07/25/2022] [Indexed: 11/12/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection. Genetic mechanisms influencing COVID-19 susceptibility are not well understood. Here, the authors analyzed whole blood RNA-seq data of 465 Japanese individuals with COVID-19, highlighting thousands of fine-mapped variants affecting expression and splicing of genes, as well as the presence of COVID-19 severity-interaction eQTLs.
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7
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Tsuburai T, Komase Y, Tsuruoka H, Oyama B, Muraoka H, Hida N, Kobayashi T, Matsushima S. The relationship between peak inspiratory flow and hand grip strength measurement in men with mild chronic obstructive pulmonary disease. BMC Pulm Med 2022; 22:65. [PMID: 35177056 PMCID: PMC8851763 DOI: 10.1186/s12890-022-01858-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 07/15/2021] [Accepted: 02/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) decreases quality of life and muscular strength. Inspiratory flow is important for inhalants in the bronchi but is complicated to measure in routine practice. We hypothesized that hand grip strength (HGS) would correlate with inhalation rate in patients with mild COPD. Methods The COPD patients were recruited at the St. Marianna University School of Medicine, Yokohama Seibu Hospital, from 2015 to 2018. We measured peak inspiratory flow (PIF) through an In-Check flow meter attached with Diskus [PIF(D)] and Turbuhaler [PIF(T)] inhalers. The 6-min walking test (6MWT), and the fraction of exhaled nitric oxide (FENO), spirometry, HGS, or forced oscillation technique (FOT) parameters were measured. Results Forty-four subjects were enrolled. All were men, with a mean age (± SD) of 77.8 ± 9.36 years. Thirty-nine patients had mild COPD. PIF(D) was 110 (80, 140) L/min (median, interquartile range), PIF(T) was 80 (70, 90) L/min, and HGS was 28.7 (13.8, 43.6) kgf. PIF(D) and PIF(T) were significantly correlated (r = 0.443, p = 0.003). PIF(D) was significantly correlated with age (r = − 0.327, p = 0.030) and HGS (r = 0.326, p = 0.031). PIF(T) was significantly correlated with age (r = − 0.328, p = 0.030), FVC (r = 0.351, p = 0.019), 6MWT distance (r = 0.392, p = 0.011), and HGS (r = 0.328, p = 0.030).
Conclusion HGS might be more useful for predicting PIF than other parameters. Also, elderly COPD patients need to be taught inhaled methods carefully.
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Affiliation(s)
- Takahiro Tsuburai
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yasashi-chou 1197-1, Asahi, Yokohama, Kanagawa, 241-0811, Japan.
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yasashi-chou 1197-1, Asahi, Yokohama, Kanagawa, 241-0811, Japan
| | - Hajime Tsuruoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yasashi-chou 1197-1, Asahi, Yokohama, Kanagawa, 241-0811, Japan
| | - Baku Oyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yasashi-chou 1197-1, Asahi, Yokohama, Kanagawa, 241-0811, Japan
| | - Hiromi Muraoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yasashi-chou 1197-1, Asahi, Yokohama, Kanagawa, 241-0811, Japan
| | - Naoya Hida
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yasashi-chou 1197-1, Asahi, Yokohama, Kanagawa, 241-0811, Japan
| | - Takayuki Kobayashi
- Department of Rehabilitation, St. Marianna University School of Medicine, Yokohama Seibu Hospital, Yokohama, Japan
| | - Shinya Matsushima
- Department of Rehabilitation, St. Marianna University School of Medicine, Yokohama Seibu Hospital, Yokohama, Japan
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Oyama B, Tsuburai T, Komase Y, Ono A, Muraoka H, Shinozaki Y, Nishiyama K, Ueno J, Nishi Y, Numata Y, Usuba AT, Yamaguchi H, Hida N. [A RESEARCH OF ADULT BRONCHIAL ASTHMATICS MANAGED UNDER YOKOHAMA CITY SEIBU HOSPITAL'S COORDINATED-CARE SYSTEM]. Arerugi 2022; 71:934-943. [PMID: 36089367 DOI: 10.15036/arerugi.71.934] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Our hospital in the western part of Yokohama City managed adult bronchial asthma patients via a coordinated care system with primary care clinics. The aim of the system is to provide effective daily and emergency medical care. METHODS The study comprised 288 adult stable asthmatics (201 women) who were examined at Yokohama City Seibu Hospital between Jan 2009 and May 2018 and who were being managed under our coordinated care system at one of 80 primary clinics or hospitals. RESULTS Of the 288 patients enrolled, 188 continued, 37 ended under management, and 63 dropped out from this system. The drop-out rate was highest at visit 1 (9%). The main reasons for end of cooperation under management were readjustment of asthma treatment and treatment for other diseases. The reasons for dropping out were low adherence, older age, and mild symptoms. There was a significant tendency in the frequency of patients who continued, ended under management, or dropped out (x2: 26.053, p=0.016), and the drop-out rate was significantly higher at visit 1. Comparing the characteristics of the patients who continued, ended under management, and dropped out within two visit, those who had dropped out were significantly younger (p=0.0067) and their duration of asthma was shorter (p=0.0009). The frequencies of emergency department visit and hospitalization were high until visit 2, but no significant trends were observed. CONCLUSION Our coordinated care system managed 188 asthmatic patients (65.2%) properly. Patients with low adherence tended to drop out from the system at visit 1.
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Affiliation(s)
- Baku Oyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Takahiro Tsuburai
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Ayami Ono
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Hiromi Muraoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yusuke Shinozaki
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Kazuhiro Nishiyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Junko Ueno
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yoshihiro Nishi
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yu Numata
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Ayano Tsukune Usuba
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Hiromichi Yamaguchi
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Yamaguchi Respiratory and Dermatology Clinic
| | - Naoya Hida
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
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Oyama B, Tsuburai T, Komase Y, Ono A, Muraoka H, Shinozaki Y, Nishiyama K, Ueno J, Nishi Y, Numata Y, Usuba AT, Yamaguchi H, Hida N. [Erratum : A RESEARCH OF ADULT BRONCHIAL ASTHMATICS MANAGED UNDER YOKOHAMA CITY SEIBU HOSPITAL'S COORDINATED-CARE SYSTEM [Japanese Journal of Allergology Vol.71 (2022) No.8 p.934-943]]. Arerugi 2022; 71:1165. [PMID: 36372429 DOI: 10.15036/arerugi.71.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Baku Oyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Takahiro Tsuburai
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Ayami Ono
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Hiromi Muraoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yusuke Shinozaki
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Kazuhiro Nishiyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Junko Ueno
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yoshihiro Nishi
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Yu Numata
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Ayano Tsukune Usuba
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Hiromichi Yamaguchi
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Yamaguchi Respiratory and Dermatology Clinic
| | - Naoya Hida
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
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Nakagama Y, Komase Y, Candray K, Nakagama S, Sano F, Tsuchida T, Kunishima H, Imai T, Shintani A, Nitahara Y, Kaku N, Kido Y. Serological Testing Reveals the Hidden COVID-19 Burden among Health Care Workers Experiencing a SARS-CoV-2 Nosocomial Outbreak. Microbiol Spectr 2021; 9:e0108221. [PMID: 34550021 PMCID: PMC8557877 DOI: 10.1128/spectrum.01082-21] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/18/2021] [Indexed: 11/20/2022] Open
Abstract
We describe the results of testing health care workers, from a tertiary care hospital in Japan that had experienced a coronavirus disease 2019 (COVID-19) outbreak during the first peak of the pandemic, for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody seroconversion. Using two chemiluminescent immunoassays and a confirmatory surrogate virus neutralization test, serological testing revealed that a surprising 42% of overlooked COVID-19 diagnoses (27/64 cases) occurred when case detection relied solely on SARS-CoV-2 nucleic acid amplification testing (NAAT). Our results suggest that the NAAT-positive population is only the tip of the iceberg and the portion left undetected might potentially have led to silent transmissions and triggered the spread. A questionnaire-based risk assessment was further indicative of exposures to specific aerosol-generating procedures (i.e., noninvasive ventilation and airway suctioning) having mediated transmission and served as the origins of the outbreak. Our observations are supportive of a multitiered testing approach, including the use of serological diagnostics, in order to accomplish exhaustive case detection along the whole COVID-19 spectrum. IMPORTANCE We describe the results of testing frontline health care workers, from a hospital in Japan that had experienced a COVID-19 outbreak, for SARS-CoV-2-specific antibodies. Antibody testing revealed that a surprising 42% of overlooked COVID-19 diagnoses occurred when case detection relied solely on PCR-based viral detection. COVID-19 clusters have been continuously striking the health care system around the globe. Our findings illustrate that such clusters are lined with hidden infections eluding detection with diagnostic PCR and that the cluster burden in total is more immense than actually recognized. The mainstays of diagnosing infectious diseases, including COVID-19, generally consist of two approaches, one aiming to detect molecular fragments of the invading pathogen and the other to measure immune responses of the host. Considering antibody testing as one trustworthy option to test our way through the pandemic can aid in the exhaustive case detection of COVID-19 patients with variable presentations.
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Affiliation(s)
- Yu Nakagama
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Katherine Candray
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Sachie Nakagama
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Fumiaki Sano
- Department of Hematology and Oncology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Tomoya Tsuchida
- Division of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takumi Imai
- Department of Medical Statistics, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Ayumi Shintani
- Department of Medical Statistics, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yuko Nitahara
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Natsuko Kaku
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yasutoshi Kido
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
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11
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Shinkai M, Tsushima K, Tanaka S, Hagiwara E, Tarumoto N, Kawada I, Hirai Y, Fujiwara S, Komase Y, Saraya T, Koh H, Kagiyama N, Shimada M, Kanou D, Antoku S, Uchida Y, Tokue Y, Takamori M, Gon Y, Ie K, Yamazaki Y, Harada K, Miyao N, Naka T, Iwata M, Nakagawa A, Hiyama K, Ogawa Y, Shinoda M, Ota S, Hirouchi T, Terada J, Kawano S, Ogura T, Sakurai T, Matsumoto Y, Kunishima H, Kobayashi O, Iwata S. Efficacy and Safety of Favipiravir in Moderate COVID-19 Pneumonia Patients without Oxygen Therapy: A Randomized, Phase III Clinical Trial. Infect Dis Ther 2021; 10:2489-2509. [PMID: 34453234 PMCID: PMC8396144 DOI: 10.1007/s40121-021-00517-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [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: 05/21/2021] [Accepted: 07/27/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is an enveloped, single-stranded RNA virus. Favipiravir is an orally administrable antiviral drug whose mechanism of action is to selectively inhibit RNA-dependent RNA polymerase. A preliminary trial in COVID-19 patients reported significant improvements across a multitude of clinical parameters, but these findings have not been confirmed in an adequate well-controlled trial. We conducted a randomized, single-blind, placebo-controlled Phase III trial assessing the efficacy and safety of favipiravir in patients with moderate pneumonia not requiring oxygen therapy. Methods COVID-19 patients with moderate pneumonia (SpO2 ≥ 94%) within 10 days of onset of fever (temperature ≥ 37.5 °C) were assigned to receive either placebo or favipiravir (1800 mg twice a day on Day 1, followed by 800 mg twice a day for up to 13 days) in a ratio of 1:2. An adaptive design was used to re-estimate the sample size. The primary endpoint was a composite outcome defined as the time to improvement in temperature, oxygen saturation levels (SpO2), and findings on chest imaging, and recovery to SARS-CoV-2-negative. This endpoint was re-examined by the Central Committee under blinded conditions. Results A total of 156 patients were randomized. The median time of the primary endpoint was 11.9 days in the favipiravir group and 14.7 days in the placebo group, with a significant difference (p = 0.0136). Favipiravir-treated patients with known risk factors such as obesity or coexisting conditions provided better effects. Furthermore, patients with early-onset in the favipiravir group showed higher odds ratio. No deaths were documented. Although adverse events in the favipiravir group were predominantly transient, the incidence was significantly higher. Conclusions The results suggested favipiravir may be one of options for moderate COVID-19 pneumonia treatment. However, the risk of adverse events, including hyperuricemia, should be carefully considered. Trial registration Clinicaltrials.jp number: JapicCTI-205238. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00517-4.
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Affiliation(s)
- Masaharu Shinkai
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Kenji Tsushima
- Department of Pulmonary Medicine, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Shingo Tanaka
- Department of Otolaryngology, Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, Tokyo, 154-8532, Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
| | - Norihito Tarumoto
- Department of Infectious Disease and Infection control, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuji Hirai
- Department of Infectious Diseases, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 193-0998, Japan
| | - Sho Fujiwara
- Department of Infectious Diseases, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama, Kanagawa, 241-0811, Japan
| | - Takeshi Saraya
- Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hidefumi Koh
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, 4-2-22 Nishiki-cho, Tachikawa, Tokyo, 190-8531, Japan
| | - Naho Kagiyama
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0197, Japan
| | - Megumi Shimada
- Department of General Internal Medicine, Tokai University Oiso Hospital, 21-1 Gakkyo, Oiso-machi, Naka-gun, Kanagawa, 259-0198, Japan
| | - Daiki Kanou
- Department of Respiratory Internal Medicine, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kohoku-ku, Yokohama, Kanagawa, 222-0036, Japan
| | - Shinichi Antoku
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa-ku, Tokyo, 133-0052, Japan
| | - Yujiro Uchida
- Department of General Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-8561, Japan
| | - Yutaka Tokue
- Infection Control and Prevention Center, Gunma University Hospital, 3-39-15 Showamachi, Maebashi, Gunma, 371-8511, Japan
| | - Mikio Takamori
- Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8524, Japan
| | - Yasuhiro Gon
- Department of Respiratory Medicine, Nihon University Itabashi Hospital, 30-1 Oyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Kenya Ie
- Department of General Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37 Shukugawara, Tama-ku, Kawasaki, Kanagawa, 214-8525, Japan
| | - Yoshitaka Yamazaki
- Department of Respiratory and Infectious Diseases, Nagano Prefectural Shinshu Medical Center, 1332 Suzaka, Suzaka, Nagano, 382-8577, Japan
| | - Kazumasa Harada
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Naoki Miyao
- Department of Internal Medicine, Nippon Koukan Hospital, 1-2-1 Kokandori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0852, Japan
| | - Takashi Naka
- Department of Neurology, Higashiosaka City Medical Center, 3-4-5 Nishiiwata, Higashiosaka, Osaka, 578-8588, Japan
| | - Mitsunaga Iwata
- Department of Emergency and General Internal Medicine, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Atsushi Nakagawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Kazutoshi Hiyama
- Department of Infectious Diseases, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan
| | - Yoshihiko Ogawa
- Department of Infectious Diseases, Sakai City Medical Center, 1-1-1 Ebarajicho, Nishi-ku, Sakai, Osaka, 593-8304, Japan
| | - Masahiro Shinoda
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Shinichiro Ota
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Takatomo Hirouchi
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Jiro Terada
- Department of Pulmonary Medicine, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Shuichi Kawano
- Department of Internal Medicine, Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, Tokyo, 154-8532, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
| | - Tsutomu Sakurai
- Scientific Information Department, FujiFilm Toyama Chemical Co., Ltd., 3-4-8 Hatchobori, Chuo-ku, Tokyo, 104-0032, Japan
| | - Yoshihiko Matsumoto
- Scientific Information Department, FujiFilm Toyama Chemical Co., Ltd., 3-4-8 Hatchobori, Chuo-ku, Tokyo, 104-0032, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, School of Medicine, St. Marianna University, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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12
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Tsuchida T, Nitahara Y, Suzuki S, Komase Y, Candray K, Kido Y, Nakagama Y, Yamasaki Y, Imamura M, Kawahata K, Kunishima H, Fujitani S, Mineshita M, Matsuda T. Back to normal; serological testing for COVID-19 diagnosis unveils missed infections. J Med Virol 2021; 93:4549-4552. [PMID: 33739483 PMCID: PMC8250857 DOI: 10.1002/jmv.26949] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/03/2021] [Accepted: 03/17/2021] [Indexed: 12/16/2022]
Abstract
Background The gold standard for coronavirus disease (COVID‐19) diagnosis has been the detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) RNA by nucleic acid amplification testing (NAAT). On the other hand, serological testing for COVID‐19 may offer advantages in detecting possibly overlooked infections by NAAT. Methods To evaluate seroconversion of NAAT‐negative pneumonia patients, immunoglobulin M (IgM) and IgG targeting the spike protein of SARS‐CoV‐2 were semiquantified by an immunofluorescence assay. Seroconversion was confirmed by another serological method, targeting the nucleocapsid protein. Results Eight suspected but unconfirmed COVID‐19 pneumonia patients (median age, 39 years; range, 21–55) were included. The median period between symptom onset and NAAT sample collection was 6 days (2–27 days). None of them had tested positive for SARS‐CoV‐2 by NAAT. In contrast, all eight patients revealed seropositivity with the two serological methods, indicating actual seroconversion against SARS‐CoV‐2. The median period between onset and blood sampling was 26.5 days (7–51 days). Conclusion Eight patients with COVID‐19 pneumonia, initially tested negative for SARS‐CoV‐2 by NAAT, were finally confirmed of the diagnosis by serological testing. To cover the whole spectrum of this heterogenous infectious disease, serology testing should be implemented to the multitiered diagnostic algorithm for COVID‐19.
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Affiliation(s)
- Tomoya Tsuchida
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuko Nitahara
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shotaro Suzuki
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-City Seibu Hospital, Yokohama, Japan
| | - Katherine Candray
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yasutoshi Kido
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yu Nakagama
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yukitaka Yamasaki
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Mitsuru Imamura
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kimito Kawahata
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shigeki Fujitani
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masamichi Mineshita
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takahide Matsuda
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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Koshiyama S, Tanimura K, Ito K, Funayama S, Hira D, Komase Y, Sato S. Gastroesophageal reflux-like symptoms are associated with hyposalivation and oropharyngeal problems in patients with asthma. Respir Investig 2020; 59:114-119. [PMID: 32665193 DOI: 10.1016/j.resinv.2020.06.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/17/2020] [Accepted: 06/04/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies have suggested a significant relationship between hyposalivation and inhalation therapy-induced oropharyngeal problems. However, salivary secretion tests are not widely performed in daily clinical practice. In fact, xerostomia, the complaint of dry mouth, may not indicate hyposalivation. Therefore, we determined the clinical factors associated with hyposalivation in patients with asthma. METHODS This study is a post-hoc analysis of our previous studies. Adult patients with asthma on maintenance inhalation therapy were enrolled. The participants completed questionnaires on oropharyngeal symptoms and underwent a salivary secretion test. Symptom severity was evaluated using a numerical rating scale (NRS), and salivary secretion was measured using the modified cotton roll method. Using logistic regression analysis, we identified the clinical factors associated with hyposalivation. RESULTS In total, 531 patients completed the questionnaire (43.8 ± 16.9 years and male/female = 171/360), and 234 patients successfully performed a salivary secretion test, of which 126 (53.8%) were diagnosed with hyposalivation (<0.25 g/min). The patients with hyposalivation were significantly older (p < 0.0001) and had severe xerostomia and/or gastroesophageal reflux-like symptoms (GERLS) (p < 0.0001). Many of these patients had also used inhaled long-acting beta agonists (p = 0.012) and high-dose inhaled corticosteroids (p = 0.024). Multivariate analysis revealed that advanced age (odds ratio [OR] 1.05, p < 0.0001), severe xerostomia (OR 1.02, p = 0.0006) and severe GERLS (OR 1.02, p = 0.001) were independently and significantly associated with hyposalivation. CONCLUSIONS Age, xerostomia, and GERLS were significantly related to hyposalivation in patients with asthma. To identify oropharyngeal problems in these patients, a careful assessment of the suspected symptoms of gastroesophageal reflux may be useful.
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Affiliation(s)
- Setsuko Koshiyama
- Kyoto Pharmaceutical Association, 563 Bairin-cho, Higashioji Gojo Agaru, Higashiyama-ku, Kyoto, 605-0863, Japan; NPO Association of Inhalation Therapist, 1197-1 Yasashi-cho, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan.
| | - Kazuya Tanimura
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan; NPO Association of Inhalation Therapist, 1197-1 Yasashi-cho, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan.
| | - Kayoko Ito
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata, 951-8520, Japan.
| | - Saori Funayama
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata, 951-8520, Japan.
| | - Daiki Hira
- College of Pharmaceutical Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan; NPO Association of Inhalation Therapist, 1197-1 Yasashi-cho, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan.
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-City Seibu Hospital, 1197-1 Yasashi-cho, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan; NPO Association of Inhalation Therapist, 1197-1 Yasashi-cho, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan.
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan; NPO Association of Inhalation Therapist, 1197-1 Yasashi-cho, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan.
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Sakaguchi T, Furuya N, Ito K, Hida N, Morikawa K, Komase Y, Inoue T, Hataji O, Mineshita M. The efficacy and safety of ramucirumab plus docetaxel in older patients with advanced non-small cell lung cancer. Thorac Cancer 2020; 11:1559-1565. [PMID: 32291896 PMCID: PMC7262941 DOI: 10.1111/1759-7714.13429] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/20/2020] [Accepted: 03/21/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Ramucirumab plus docetaxel (RAM+DOC) is expected to prolong survival in patients with advanced non-small cell lung cancer (NSCLC); however, the efficacy and safety for older patients remains unknown. The objective of this study was to evaluate the efficacy and safety of RAM+DOC in patients 75 years and older. METHODS We retrospectively reviewed consecutive patients with advanced NSCLC who had received RAM+DOC treatment at three institutions. We compared the efficacy and safety in patients 75 years and older to those under 75 years of age. RESULTS A total of 114 patients were identified. The median progression-free survival, time to treatment failure and overall survival was 3.6 (95% CI: 0.4-6.7), 3.1 (95% CI: 2.4-3.9) and 11.2 months (95% CI: 5.6-16.8) in the older group (N = 23), and 4.2 (95% CI: 3.3-5.0), 3.4 (95% CI: 3.3-5.0) and 12.2 months (95% CI: 9.1-15.4) in the younger group (N = 91), respectively. Survival curves were similar for each group, while the objective response rate was 30.4% (95% CI: 13.2-52.9%) in older patients and 35.2% (95% CI, 25.4-45.9%) for the younger group. A total of 22 older patients (95.7%) and 73 (80.2%) younger patients received primary prophylactic pegylated-granulocyte-colony stimulating factor (PEG-G-CSF). Four older patients (17.3%) and 14 younger patients (15.3%) discontinued RAM+DOC due to adverse events. CONCLUSIONS RAM+DOC is expected to be efficacious and tolerable in older patients when supported with prophylactic PEG-G-CSF therapy. KEY POINTS Significant findings of the study ・PFS, OS, and ORR in older patients were similar to those under 75 years of age. ・Safety of RAM+DOC was well tolerated in older patients with prophylactic PEG-G-CSF. ・Prophylactic PEG-G-CSF with RAM+DOC may contribute to better efficacy. What this study adds ・This study suggests that RAM+DOC with prophylactic PEG-G-CSF is expected to be a useful option in older patients with advanced NSCLC.
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Affiliation(s)
- Tadashi Sakaguchi
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kentaro Ito
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Naoya Hida
- Division of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama, Japan
| | - Kei Morikawa
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuko Komase
- Division of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama, Japan
| | - Takeo Inoue
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Osamu Hataji
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Masamichi Mineshita
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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Furuya N, Ito K, Sakaguchi T, Hida N, Kakinuma K, Morikawa K, Inoue T, Komase Y, Hataji O, Mineshita M. The Impact of EGFR Mutation Status and Brain Metastasis for Non-Small Cell Lung Cancer Treated with Ramucirumab plus Docetaxel. Oncology 2020; 98:661-668. [PMID: 32464632 PMCID: PMC7592951 DOI: 10.1159/000507050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 01/26/2020] [Accepted: 03/05/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Currently, combination therapy of ramucirumab (RAM) + docetaxel (DOC) must play a more important role as a second-line treatment. Epithelial growth factor receptor (EGFR) mutation accounts for around 50% of oncogenic driver mutations in patients with advanced non-small cell lung cancer (NSCLC) in Asian subsets. The number of brain metastases (BM) is relatively higher in EGFR mutation-positive patients compared to EGFR wild-type patients. The objective of this study is to evaluate the efficacy of RAM + DOC focusing on EGFR mutation and BM. METHODS We retrospectively reviewed consecutive advanced NSCLC patients who received combination therapy of RAM + DOC at three institutions. A total of 112 patients with NSCLC were enrolled for efficacy analyses. We evaluated the efficacy of RAM + DOC for EGFR-mutated NSCLC with endpoints including progression-free survival (PFS), time to treatment failure (TTF) and overall survival. RESULTS Median PFS was 5.7 months for the EGFR mutant group compared with 3.6 months for the EGFR wild-type group (HR 0.53, 95% CI 0.32-0.87; p = 0.01). Median TTF was 5.1 months for the EGFR mutant group compared with 2.8 months for the EGFR wild-type group (HR 0.53, 95% CI 0.33-0.85; p = 0.007). Median PFS and TTF of the EGFR mutant group was significantly longer than median PFS and TTF of the EGFR wild-type group. The multivariate analysis identified EGFR mutation status as an independent favorable factor of PFS. In subset analyses of BM, median PFS of the EGFR mutant group (2.8 months) was significantly shorter than that of the EGFR wild-type group (5.1 months) (HR 7.27, 95% CI 1.78-29.68; p = 0.002). CONCLUSION This study revealed that EGFR mutation status and BM might be predictive or prognostic factors for PFS.
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Affiliation(s)
- Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan,
| | - Kentaro Ito
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Tadashi Sakaguchi
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Naoya Hida
- Division of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Kazutaka Kakinuma
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kei Morikawa
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takeo Inoue
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuko Komase
- Division of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Osamu Hataji
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Masamichi Mineshita
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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16
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Kato H, Shimizu H, Shibue Y, Hosoda T, Iwabuchi K, Nagamine K, Saito H, Sawada R, Oishi T, Tsukiji J, Fujita H, Furuya R, Masuda M, Akasaka O, Ikeda Y, Sakamoto M, Sakai K, Uchiyama M, Watanabe H, Yamaguchi N, Higa R, Sasaki A, Tanaka K, Toyoda Y, Hamanaka S, Miyazawa N, Shimizu A, Fukase F, Iwai S, Komase Y, Kawasaki T, Nagata I, Nakayama Y, Takei T, Kimura K, Kunisaki R, Kudo M, Takeuchi I, Nakajima H. Clinical course of 2019 novel coronavirus disease (COVID-19) in individuals present during the outbreak on the Diamond Princess cruise ship. J Infect Chemother 2020; 26:865-869. [PMID: 32405245 PMCID: PMC7218347 DOI: 10.1016/j.jiac.2020.05.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 04/13/2020] [Revised: 05/02/2020] [Accepted: 05/07/2020] [Indexed: 01/08/2023]
Abstract
We investigated the clinical course of individuals with 2019 novel coronavirus disease (COVID-19) who were transferred from the Diamond Princess cruise ship to 12 local hospitals. The conditions and clinical courses of patients with pneumonia were compared with those of patients without pneumonia. Among 70 patients (median age: 67 years) analyzed, the major symptoms were fever (64.3%), cough (54.3%), and general fatigue (24.3%). Forty-three patients (61.4%) had pneumonia. Higher body temperature, heart rate, and respiratory rate as well as higher of lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and C-reactive protein (CRP) levels and lower serum albumin level and lymphocyte count were associated with the presence of pneumonia. Ground-glass opacity was found in 97.7% of the patients with pneumonia. Patients were administered neuraminidase inhibitors (20%), lopinavir/ritonavir (32.9%), and ciclesonide inhalation (11.4%). Mechanical ventilation and veno-venous extracorporeal membrane oxygenation was performed on 14 (20%) and 2 (2.9%) patients, respectively; two patients died. The median duration of intubation was 12 days. The patients with COVID-19 transferred to local hospitals during the outbreak had severe conditions and needed close monitoring. The severity of COVID-19 depends on the presence of pneumonia. High serum LDH, AST and CRP levels and low serum albumin level and lymphocyte count were found to be predictors of pneumonia. It was challenging for local hospitals to admit and treat these patients during the outbreak of COVID-19. Assessment of severity was crucial to manage a large number of patients.
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Affiliation(s)
- Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Japan; Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Japan.
| | - Hiroyuki Shimizu
- Department of Clinical Laboratory Medicine, Fujisawa City Hospital, Japan
| | - Yasushi Shibue
- Department of Infectious Diseases, Yokohama City Minato Red Cross Hospital, Japan
| | - Tomohiro Hosoda
- Department of Infectious Diseases, Kawasaki Municipal Kawasaki Hospital, Japan
| | - Keisuke Iwabuchi
- Department of General Medicine, Kanagawa Prefectural Ashigarakami Hospital, Japan
| | | | - Hiroki Saito
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Japan
| | - Reimin Sawada
- Department of Cardiology, Japanese Red Cross Hadano Hospital, Japan
| | - Takayuki Oishi
- Department of Infection Control and Prevention, Saiseikai Yokohamashi Tobu Hospital, Japan
| | - Jun Tsukiji
- Department of Prevention and Infection Control, Yokohama City University Medical Center, Japan
| | - Hiroyuki Fujita
- Infection Control Committee, Saiseikai Yokohama Nanbu Hospital, Japan
| | - Ryosuke Furuya
- Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Japan
| | - Makoto Masuda
- Department of Respiratory Medicine, Fujisawa City Hospital, Japan
| | - Osamu Akasaka
- Emergency Medical Center, Fujisawa City Hospital, Japan
| | - Yu Ikeda
- Emergency Medical Center, Fujisawa City Hospital, Japan
| | - Mitsuo Sakamoto
- Department of Infectious Diseases, Kawasaki Municipal Kawasaki Hospital, Japan
| | - Kazuya Sakai
- Department of Emergency Medicine, Yokohama City University School of Medicine, Japan
| | - Munehito Uchiyama
- Department of Emergency Medicine, Yokohama City University School of Medicine, Japan
| | - Hiroki Watanabe
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Japan
| | | | - Ryoko Higa
- Department of Prevention and Infection Control, Yokohama City University Medical Center, Japan
| | - Akiko Sasaki
- Nursing Department, Japanese Red Cross Hadano Hospital, Japan
| | - Katsuaki Tanaka
- Department of Gastroenterology, Japanese Red Cross Hadano Hospital, Japan
| | - Yukitoshi Toyoda
- Department of Emergency and Critical Care Medicine Major Trauma Center Trauma & Acute Care Surgery, Saiseikai Yokohamashi Tobu Hospital, Japan
| | - Shinsuke Hamanaka
- Department of Pulmonary Medicine, Saiseikai Yokohamashi Tobu Hospital, Japan
| | - Naoki Miyazawa
- Department of Respiratory Medicine, Saiseikai Yokohama Nanbu Hospital, Japan
| | - Atsuko Shimizu
- Infection Control Team, National Yokohama Medical Center, Japan
| | - Fumie Fukase
- Infection Control Team, National Yokohama Medical Center, Japan
| | - Shunsuke Iwai
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Japan
| | - Tsutomu Kawasaki
- Department of Respiratory Medicine, Yokohama City Minato Red Cross Hospital, Japan
| | - Isao Nagata
- Intensive Care Unit, Yokohama City Minato Red Cross Hospital, Japan
| | - Yusuke Nakayama
- Emergency Department, Yokohama City Minato Red Cross Hospital, Japan
| | - Tetsuhiro Takei
- Intensive Care Unit, Yokohama City Minato Red Cross Hospital, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center, Japan
| | - Reiko Kunisaki
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
| | - Makoto Kudo
- Respiratory Disease Center, Yokohama City University Medical Center, Japan
| | - Ichiro Takeuchi
- Kanagawa Disaster Medical Assistance Team, Japan; Advanced Emergency Medical Service Center, Yokohama City University Medical Center, Japan
| | - Hideaki Nakajima
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Japan
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17
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Tomomatsu K, Oguma T, Baba T, Toyoshima M, Komase Y, Taniguchi M, Asano K. Effectiveness and Safety of Omalizumab in Patients with Allergic Bronchopulmonary Aspergillosis Complicated by Chronic Bacterial Infection in the Airways. Int Arch Allergy Immunol 2020; 181:499-506. [PMID: 32388510 DOI: 10.1159/000507216] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/13/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Allergic bronchopulmonary aspergillosis (ABPA) develops in the presence of predisposing conditions such as asthma and cystic fibrosis. Even ABPA accompanied by asthma is often complicated by chronic Pseudomonas aeruginosa or nontuberculous mycobacterial infection of the lower respiratory tract, rendering treatment with corticosteroids difficult. There have been several reports on the effectiveness of omalizumab, an anti-IgE antibody, in patients with ABPA. We analyzed the effectiveness and adverse effects of omalizumab in ABPA patients with chronic respiratory infections. METHODS Using our nationwide survey database and published case reports, we identified patients with severe asthma and ABPA who fulfilled the International Society for Human and Animal Mycology criteria and who had been treated with omalizumab. Exacerbation rates, control of symptoms, doses of oral corticosteroids, and pulmonary function were evaluated. RESULTS Among 25 patients with ABPA treated with omalizumab (median age 62 years, range 33-83 years), 12 patients had a chronic bacterial infection of the lower airways attributable to P. aeruginosa (n = 6) or nontuberculous mycobacteria (n = 6) at the initiation of omaliz-umab. Treatment with omalizumab reduced the frequency of exacerbations and systemic corticosteroid doses and improved pulmonary function. There were no significant adverse events or worsening of infection during treatment with omalizumab, except for injection-site reactions. CONCLUSIONS Treatment with omalizumab was effective and safe in patients with ABPA, regardless of comorbid chronic respiratory tract infections.
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Affiliation(s)
- Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tomohisa Baba
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Mikio Toyoshima
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Shizuoka, Japan
| | - Yuko Komase
- Department of Respiratory Medicine, Yokohama-City Seibu Hospital, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masami Taniguchi
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan,
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18
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Muraoka H, Tsuburai T, Komase Y, Ono A, Oyama B, Tsuruoka H, Usuba A, Hida N, Mineshita M. [CHARACTERISTICS OF ADULT ASTHMATICS COMPLICATED WITH PULMONARY THROMBOEMBOLISM IN YOKOHAMA CITY SEIBU HOSPITAL]. Arerugi 2020; 69:119-122. [PMID: 32188823 DOI: 10.15036/arerugi.69.119] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Evidences have shown that bronchial asthma (BA) enhances the risk of pulmonary thromboembolism (PTE). We previously reported the cases of adult BA patients complicated with PTE. (Aim) To clarify the risk factors of PTE in BA patients, we investigated about the characteristics and risk of contrast medium about patients coexisting asthma and PTE. METHODS We investigated adult asthmatics who visited our hospital and examined chest contrasted CT from January 2011 to 2018.March, retrospectively. RESULTS Fifty seven times examinations (33 asthmatics) were detected from 304 times of enhanced chest CT. We examined twenty times enhanced CT without premedication, but no subjects had side effect such as asthma attack. And also, we diagnosed 12 asthmatics as PTE from 33 patients. The subjects with PTE were high BMI (p=0.024) heavy weight (p=0.033), compared with asthmatics without PTE. There were no significant changes about lung function test, smoking history, sex and the levels of D-dimer among two groups. CONCLUSION Adult asthmatics with PTE were high BMI and heavy compared with those without PTE.
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Affiliation(s)
- Hiromi Muraoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital.,Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Takahiro Tsuburai
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Ayami Ono
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Baku Oyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital.,Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Hajime Tsuruoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital.,Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Ayano Usuba
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Naoya Hida
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Masamichi Mineshita
- Department of Respiratory Medicine, St. Marianna University School of Medicine
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19
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Nishida K, Tsuburai T, Komase Y, Tsuruoka H, Oyama B, Muraoka H, Usuba AT, Hida N, Inoue T, Mineshita M. Relationships among bronchodilator reversibility, the fraction of exhaled nitric oxide, and the parameters of the forced oscillation technique in adult asthma treated with inhaled corticosteroids and long-acting β2 agonists combination. J Breath Res 2020; 14:026013. [PMID: 32120351 DOI: 10.1088/1752-7163/ab7b8c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In bronchial asthma, both airway inflammation and reversible airway narrowing require assessment and treatment. These two pathologies are treated primarily with inhaled corticosteroids (ICS) and long-acting β2 agonists (LABA), respectively. Therefore, ICS-LABA combinations are widely used to treat asthma. Airway inflammation and reversible airway narrowing are assessed primarily with fraction of exhaled nitric oxide (FENO) and bronchodilator reversibility (BDR). The forced oscillation technique (FOT) has recently attracted attention as a method for assessing obstructive respiratory disturbance. However, little is known about the relationships among these assessments. Therefore, we investigated the relationships among BDR, FENO, and FOT during ICS-LABA combination therapy. The subjects comprised 87 patients (25 men and 62 women) with asthma undergoing ICS/LABA combination therapy from July to September 2017. We applied the FENO test, FOT, and BDR testing without the patients stopping their therapy. The rates of change in FEV1 (ΔFEV1%) was correlated with FENO (r = 0.278). Among the FOT parameters, X5 (r = -0.263), Fres (r = 0.292), and AX (r = 0.245) were significantly correlated with ΔFEV1%. FENO, Fres and %FEV1 at baseline in these stable asthmatics were significantly assosiated with ΔFEV1% independently of the effects of age, atopy and body mass index (BMI). These results suggest that FENO and the results of respiratory function testing and FOT reflect different aspects of asthma and should be combined and comprehensively evaluated.
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Affiliation(s)
- Kohei Nishida
- Department of Respiratory Medicine, St. Marianna University school of Medicine, Yokohama City Seibu Hospital, Yasashi-chou 1197-1, Asahi, Yokohama, Kanagawa 241-0811, Japan. Department of Respiratory Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
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20
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Muraoka H, Tsuburai T, Komase Y, Ono A, Oyama B, Tsuruoka H, Usuba A, Hida N, Mineshita M. [Erratum : CHARACTERISTICS OF ADULT ASTHMATICS COMPLICATED WITH PULMONARY THROMBOEMBOLISM IN YOKOHAMA CITY SEIBU HOSPITAL [Japanese Journal of Allergology Vol.69 (2020) No.2 p.119-122]]. Arerugi 2020; 69:451. [PMID: 32684554 DOI: 10.15036/arerugi.69.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Hiromi Muraoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Takahiro Tsuburai
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Ayami Ono
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Baku Oyama
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Hajime Tsuruoka
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Ayano Usuba
- Department of Respiratory Medicine, St. Marianna University School of Medicine
| | - Naoya Hida
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
| | - Masamichi Mineshita
- Department of Respiratory Medicine, St. Marianna University School of Medicine
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21
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Oyama B, Tsuburai T, Tsuruoka H, Nishida K, Usuba A, Hida N, Inoue T, Komase Y, Mineshita M, Miyazawa T. Complicating effects of obstructive sleep apnea syndrome on the severity of adult asthma. J Asthma 2019; 57:1173-1178. [PMID: 31449432 DOI: 10.1080/02770903.2019.1652643] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Bronchial asthma (BA) and obstructive sleep apnea syndrome (OSAS) are common causes of respiratory disturbance. Many cases of patients with both conditions have been reported, and BA and OSAS may exacerbate each other, but information remains sparse.Methods:We retrospectively evaluated 60 patients under treatment for BA in our department between April 2016 and March 2018 who also underwent portable polysomnography (PSG) for suspected OSAS to assess potential association between PSG results and asthma treatment or respiratory function. BA was diagnosed and treated according to the Asthma Prevention and Management Guideline 2015.Results: We found that BA treatment intensity step was significantly higher for patients with BA who had concurrent moderate or severe OSAS (p = 0.0016). However, neither respiratory function, fraction of exhaled nitric oxide (FeNO), nor forced oscillation technique (FOT) differed significantly between patients with and without OSAS, and apnea hypopnea index was not significantly correlated with respiratory function, FeNO or FOT parameters.Conclusion:We conclude that even though BA patients with OSAS had good respiratory function, their BA was more severe than that of patients without OSAS, suggesting that OSAS may exacerbate BA. Background factors and asthma parameters were not predictive of PSG results, and patients with suspected OSAS should be evaluated proactively by using PSG.
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Affiliation(s)
- Baku Oyama
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Takahiro Tsuburai
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Hajime Tsuruoka
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Kouhei Nishida
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Ayano Usuba
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Naoya Hida
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Takeo Inoue
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Yuko Komase
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Masamichi Mineshita
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Teruomi Miyazawa
- Division of Respiratory Diseases, Saint Marianna University School of Medicine, Kawasaki, Japan
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22
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Oyama B, Tsuburai T, Komase Y, Nishida K, Tsuruoka H, Usuba A, Muraoka H, Hida N, Mineshita M. [A CASE OF BRONCHIAL ASTHMA ASSOCIATED WITH BRONCHIOLAR EOSINOPHILIA AND TREATED WITH MEPOLIZUMAB]. Arerugi 2019; 68:101-106. [PMID: 30867360 DOI: 10.15036/arerugi.68.101] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 68 year-old woman with dyspnea and cough had been treated with inhaled corticosteroids for X-15 years, but her symptoms worsened in X year. High-resolution chest CT revealed small centrilobular nodules in the right upper lobe in March X year. The patient was diagnosed with asthma and diffuse panbronchiolitis and treated with inhaled corticosteroids, a long-acting beta agonist, and clarithromycin, but her condition did not improve and her peripheral blood eosinophil count increased. In August X year, we performed a transbronchial biopsy of the right upper lung. Histopathological examination revealed eosinophilia in the bronchial secretions and mild nonspecific inflammatory changes. The diagnosis was bronchial asthma associated with bronchiolitis. The patient was treated successfully with mepolizumab.
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Affiliation(s)
- Baku Oyama
- Department of Respiratory Medicine, St. Marianna University, Yokohama City Seibu Hospital.,Department of Respiratory Medicine, St. Marianna University
| | - Takahiro Tsuburai
- Department of Respiratory Medicine, St. Marianna University, Yokohama City Seibu Hospital
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University, Yokohama City Seibu Hospital
| | - Kohei Nishida
- Department of Respiratory Medicine, St. Marianna University, Yokohama City Seibu Hospital.,Department of Respiratory Medicine, St. Marianna University
| | - Hajime Tsuruoka
- Department of Respiratory Medicine, St. Marianna University, Yokohama City Seibu Hospital.,Department of Respiratory Medicine, St. Marianna University
| | - Ayano Usuba
- Department of Respiratory Medicine, St. Marianna University
| | - Hiromi Muraoka
- Department of Respiratory Medicine, St. Marianna University, Yokohama City Seibu Hospital
| | - Naoya Hida
- Department of Respiratory Medicine, St. Marianna University, Yokohama City Seibu Hospital
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23
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Horinouchi H, Asano F, Okubo K, Okada Y, Ohsaki Y, Komase Y, Hashizume T, Kohno M, Aoe M. Current status of diagnostic and therapeutic bronchoscopy in Japan: 2016 national survey of bronchoscopy. Respir Investig 2019; 57:238-244. [PMID: 30738922 DOI: 10.1016/j.resinv.2018.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 09/12/2018] [Revised: 11/11/2018] [Accepted: 12/07/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The safety management committee of the Japan Society for Respiratory Endoscopy (JSRE) conducted national surveys to clarify the state of diagnostic and therapeutic bronchoscopy in 2016. METHODS Questionnaire forms were mailed to 532 JSRE-accredited facilities throughout Japan. We surveyed the actual condition of clinical practice and cases of bronchoscopy during 2016. RESULTS Four hundred and thirty-three facilities responded giving a response rate of 81.4%; 67.6% held more than 400 beds. The average number of board accredited senior Fellows and Fellows per facility was 1.9 and 3.2, respectively. Diagnostic bronchoscopy was performed in a hospitalized setting in 74.6% of all facilities. The radial type ultrasound probe was operated in 51.7% of all facilities. The number of facilities has markedly increased compared with that reported in the 2010 survey (19.6%). The bronchoscopic navigation system had been in operation in 41.7% of all facilities. Antithrombotic drugs were adjusted before biopsy in 96.8% of all facilities. For intravenous sedation, midazolam was the first choice in 76.9% of all facilities. Endobronchial ultrasound guided transbronchial lymph node needle aspiration (EBUS-TBNA) has become popular over the decade (19.6% in 2010 to 68.1% in 2016). The mean number of the board accredited senior Fellows and board accredited Fellows increased in comparison with that in 2010. As a new technique, radial type ultrasound-guided peripheral approach has become popular. CONCLUSIONS Through this survey, the advanced safety of bronchoscopic examination has been secured in many facilities. A continuous monitoring of bronchoscopic practices with respect to safety management is recommended.
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Affiliation(s)
- Hirohisa Horinouchi
- Department of General Thoracic Surgery, Saitama City Hospital, 246 Midori-ku, Saitama-city, Saitama 366-8522, Japan.
| | - Fumihiro Asano
- Department of Pulmonary Medicine, Gifu Prefectural General Medical Center, Gifu, 500-8717, Japan.
| | - Kenichi Okubo
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, TMDU, Tokyo 113-8510, Japan.
| | - Yoshinori Okada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Miyagi 980-8575, Japan.
| | - Yoshinobu Ohsaki
- Respiratory Center, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University, School of Medicine, Yokohama-City Seibu Hospital, Kanagawa 241-0811, Japan.
| | - Toshinori Hashizume
- Department of General Thoracic Surgery, NHO Kanagawa National Hospital, Kanagawa 257-8585, Japan.
| | - Mitsutomo Kohno
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Kanagawa 259-1193, Japan.
| | - Motoi Aoe
- Kagawa Kenritsu Chuo Hospital, Kagawa 760-8557, Japan.
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Hira D, Koide H, Nakamura S, Okada T, Ishizeki K, Yamaguchi M, Koshiyama S, Oguma T, Ito K, Funayama S, Komase Y, Morita SY, Nishiguchi K, Nakano Y, Terada T. Assessment of inhalation flow patterns of soft mist inhaler co-prescribed with dry powder inhaler using inspiratory flow meter for multi inhalation devices. PLoS One 2018; 13:e0193082. [PMID: 29462195 PMCID: PMC5819805 DOI: 10.1371/journal.pone.0193082] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 01/22/2018] [Indexed: 11/19/2022] Open
Abstract
The patients’ inhalation flow pattern is one of the significant determinants for clinical performance of inhalation therapy. However, the development of inhalation flow meters for various inhalation devices has been unable to keep up with the increasing number of newly launched inhalation devices. In the present study, we developed simple attachment orifices for the inhalation flow pattern monitoring system, which are suitable for all commercial inhalers, and investigated the efficacy of the system on the clinical inhalation instruction for patients co-prescribed dry powder inhaler (DPI) and soft mist inhaler (SMI). First, we constructed simple attachment orifices that were adjusted for 13 commercial inhalers, and examined the correlation between orifice and inhalation device. Second, the inhalation flow patterns (peak inspiratory flow rate, PIFR; inhalation duration time, DT) of patients prescribed a combination of DPI and SMI were monitored before and after inhalation instruction. The inhalation resistance of commercial inhalers are listed in the following order; Twincaps® > Handihaler® > Swinghaler® = Clickhaler® > Twisthaler® > Turbuhaler® > Jenuair® > Diskus® = Ellipta® > Diskhaler® > Breezhaler® > Respimat® = pMDI. The pressure drop via orifice was significantly correlated with that via the commercial inhaler. For the confirmation, all participants achieved the DPI criterion of PIFR. On the other hand, 4 participants (6 clinical visits) of 10 experimented participants could not achieve the essential criterion of DT (> 1.5 sec) for SMI, but all participants improved their duration time after inhalation instruction by pharmacists (P<0.05). In the present study, we successfully developed simple attachment orifice suitable for 13 commercial inhalation devices. These data suggested that our simple attachment orifices for the inhalation flow pattern monitoring system can detect patients with inadequate inhalation patterns via SMI.
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Affiliation(s)
- Daiki Hira
- Department of Pharmacy, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
| | - Hiroyoshi Koide
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kyoto Pharmaceutical University, Kyoto, Kyoto, Japan
| | | | - Toyoko Okada
- Hitachi Automotive Systems, Ltd., Isesaki, Gunma, Japan
| | | | - Masafumi Yamaguchi
- Department of Medicine, Division of Respiratory Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | | | | | - Kayoko Ito
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Niigata, Japan
| | - Saori Funayama
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Niigata, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University, School of Medicine, Yokohama-City Seibu Hospital, Yokohama, Kanagawa, Japan
| | - Shin-ya Morita
- Department of Pharmacy, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
| | - Kohshi Nishiguchi
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kyoto Pharmaceutical University, Kyoto, Kyoto, Japan
| | - Yasutaka Nakano
- Department of Medicine, Division of Respiratory Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Tomohiro Terada
- Department of Pharmacy, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
- * E-mail:
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Terasaki Y, Ikushima S, Matsui S, Hebisawa A, Ichimura Y, Izumi S, Ujita M, Arita M, Tomii K, Komase Y, Owan I, Kawamura T, Matsuzawa Y, Murakami M, Ishimoto H, Kimura H, Bando M, Nishimoto N, Kawabata Y, Fukuda Y, Ogura T. Comparison of clinical and pathological features of lung lesions of systemic IgG4-related disease and idiopathic multicentric Castleman's disease. Histopathology 2017; 70:1114-1124. [PMID: 28207938 DOI: 10.1111/his.13186] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 09/19/2016] [Revised: 01/30/2017] [Accepted: 02/11/2017] [Indexed: 12/11/2022]
Abstract
AIMS The lung lesion [immunoglobulin (Ig)G4-L] of IgG4-related disease (IgG4-RD) is a condition that occurs together with IgG4-RD and often mimics the lung lesion [idiopathic multicentric Castleman's disease (iMCD-L)] of idiopathic multicentric Castleman's disease (iMCD). Because no clinical and pathological studies had previously compared features of these diseases, we undertook this comparison with clinical and histological data. METHODS AND RESULTS Nine patients had IgG4-L (high levels of serum IgG4 and of IgG4+ cells in lung specimens; typical extrapulmonary manifestations). Fifteen patients had iMCD-L (polyclonal hyperimmunoglobulinaemia, elevated serum interleukin-6 levels and polylymphadenopathy with typical lymphadenopathic lesions). Mean values for age, serum haemoglobin levels and IgG4/IgG ratios were higher in the IgG4-L group and C-reactive protein levels were higher in the iMCD-L group. All IgG4-RD lung lesions showed myxomatous granulation-like fibrosis (active fibrosis), with infiltration of lymphoplasmacytes and scattered eosinophils within the perilymphatic stromal area, such as interlobular septa and pleura with obstructive vasculitis. All 15 lung lesions of iMCD, however, had marked accumulation of polyclonal lymphoplasmacytes in lesions with lymphoid follicles and dense fibrosis, mainly in the alveolar area adjacent to interlobular septa and pleura without obstructive vasculitis. CONCLUSIONS Although both lesions had lymphoplasmacytic infiltration, lung lesions of IgG4-RD were characterized by active fibrosis with eosinophilic infiltration within the perilymphatic stromal area with obstructive vasculitis, whereas lung lesions of iMCD had lymphoplasmacyte proliferating lesions mainly in the alveolar area adjacent to the perilymphatic stromal area. These clinicopathological features may help to differentiate the two diseases.
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Affiliation(s)
- Yasuhiro Terasaki
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan
| | - Soichiro Ikushima
- Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Shoko Matsui
- Health Administration Center, University of Toyama, Toyama, Japan
| | - Akira Hebisawa
- Division of Clinical Pathology, NHO Tokyo National Hospital, Tokyo, Japan
| | - Yasunori Ichimura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masuo Ujita
- Department of Radiology, Nishigunma National Hospital, Shibukawa, Japan
| | - Machiko Arita
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuko Komase
- Department of Respiratory Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Isoko Owan
- Department of Respiratory Medicine, National Hospital Organization Okinawa National Hospital, Ginowan, Okinawa, Japan
| | - Tetsuji Kawamura
- Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, Hyogo, Japan
| | - Yasuo Matsuzawa
- Department of Respiratory Medicine, Toho University Medical Center-Sakura Hospital, Chiba, Japan
| | - Miho Murakami
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Osaka, Japan.,Osaka Rheumatology Clinic, Osaka, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroshi Kimura
- Department of Respiratory Medicine, Nara Medical University, Nara, Japan
| | - Masashi Bando
- Department of Respiratory Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Osaka, Japan.,Osaka Rheumatology Clinic, Osaka, Japan
| | - Yoshinori Kawabata
- Division of Diagnostic Pathology, Saitama Prefectural Cardiovascular and Respiratory Center, Saitama, Japan
| | - Yuh Fukuda
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan
| | - Takashi Ogura
- Division of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
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Usuba A, Komase Y, Oyama B, Tsuburai T, Hida N. [A CASE OF PERTUSSIS IN ADULT THAT COULD BE DIAGNOSED BY DETECTION OF BORDETELLA PERTUSSIS FROM SPUTUM]. Arerugi 2017; 66:1230-1235. [PMID: 29249756 DOI: 10.15036/arerugi.66.1230] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Bordetella pertussis isolation by culture has low detection sensitivity for diagnosing pertussis; the diagnosis is confirmed by measuring serum anti-pertussis toxin (anti-PT) or anti-filamentous hemagglutinin antibody titers, and by genetic testing (polymerase chain reaction/loop-mediated isothermal amplification). Isolation of B. pertussis in adults is difficult, resulting in a delayed diagnosis, as a delayed cough may present ≥3 months after onset. Differentiation from bronchial asthma is also important. We encountered an adult patient in whom B. pertussis was isolated by culture who previously received rituximab for mucosa-associated lymphoid tissue (MALT) lymphoma and steroids for prolonged cough. No elevation of anti-PT antibody titers was observed in the patient.
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Affiliation(s)
- Ayano Usuba
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital
| | - Yuko Komase
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital
| | - Baku Oyama
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital
| | - Takahiro Tsuburai
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital
| | - Naoya Hida
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital
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27
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Hira D, Komase Y, Koshiyama S, Oguma T, Hiramatsu T, Shiraki A, Nishikawa M, Nakanishi M, Tsuji T, Matsumoto H, Ichimura K, Iwanaga T, Morikawa M, Yasuba H, Sugaya F, Arakawa Y, Kobayashi Y, Kato T, Futamura Y, Tsuji F, Terada T. Problems of elderly patients on inhalation therapy: Difference in problem recognition between patients and medical professionals. Allergol Int 2016; 65:444-449. [PMID: 27155752 DOI: 10.1016/j.alit.2016.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/24/2016] [Accepted: 04/03/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is no systematic analysis to identify problems involved with instruction on inhalation therapy for elderly patients. We conducted a nationwide questionnaire survey for patients and medical professionals. METHODS A questionnaire survey was conducted of adult patients on inhaled drugs (ages 18-92 years, 820 individuals) and medical professionals (pharmacists or nurses) who provided instruction on inhalation therapy to these patients in 23 institutions in Japan to investigate the technique and the level of understanding (knowledge) of the inhalation therapy. Changes in the recognition of performance of inhalation technique and inhalation knowledge with increasing age were analyzed. RESULTS According to patients' subjective assessment, there was no deterioration in the performance of the inhalation technique or loss of the knowledge with increasing age. On the other hand, medical professionals' objective assessment revealed a significant loss of both inhalation technique and knowledge with increasing age. Not many elderly patients noticed their own problems themselves, revealing a great perception gap between elderly patients and medical professionals. Thus, there was concern that patients would unconsciously practice the inhalation procedure improperly. On the other hand, in comparison with non-elderly patients, elderly patients were less resistant to continuation of therapy, suggesting that they would be more likely to accept instruction on inhalation therapy. CONCLUSIONS Elderly patients are apt to assume that they "understand well", therefore, in order to recognize and close the perception gap between elderly patients and medical professionals, it is necessary to provide them with more aggressive (frequent) instructions on inhalation therapy.
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28
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Komase Y. [Interviewing of patients, physical findings, laboratory findings]. Nihon Rinsho 2016; 74:1628-1633. [PMID: 30551272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
When diagnosing bronchial asthma, it is necessary to make a comprehensive assessment of the information obtained by interviewing the patient, physical findings, and laboratory findings, while taking into consideration the course of the condition. This is not an easy task unless it is a classic case. On the other hand, based on the information obtained from the patient interview, it is possible to make predictions to some extent and conduct laboratory tests accordingly. During the patient interview, considerations should be given to other possible diseases, concomitant diseases, degree of severity with/without attacks.
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Yamada K, Aono H, Hosomi Y, Okamoto H, Kato T, Komase Y, Nishikawa M, Azuma K, Takeoka H, Okuma Y, Nakahara Y, Sato A, Oba MS, Morita S, Kunitoh H, Watanabe K. A prospective, multicentre phase II trial of low-dose erlotinib in non-small cell lung cancer patients with EGFR mutations pretreated with chemotherapy: Thoracic Oncology Research Group 0911. Eur J Cancer 2015; 51:1904-10. [PMID: 26174465 DOI: 10.1016/j.ejca.2015.06.120] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 04/24/2015] [Revised: 05/26/2015] [Accepted: 06/13/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Low-dose erlotinib may be as effective as gefitinib or erlotinib at full dose in non-small cell lung cancer (NSCLC) patients with activating mutations of the epidermal growth factor receptor (EGFR) gene. METHODS Patients with chemotherapy pretreated NSCLC harbouring EGFR mutations received erlotinib at 50 mg/d until disease progression or unacceptable toxicities. The dose was escalated to 150 mg/d in patients showing no response (i.e. without major tumour shrinkage according to Response Evaluation Criteria in Solid Tumours (RECIST)) to the initial dose during the first 4 weeks. The primary end-point was the objective response rate at the dose of 50 mg/d. RESULTS Thirty-four patients from seven institutes were enrolled. The study was closed early when no response was confirmed in 15 patients, excluding the possibility that the primary end-point would be met. The objective response and disease control rates at the dose of 50 mg/d as determined by an independent review committee were 54.5% and 84.8%, respectively. Four additional patients achieved partial response with increased 150 mg/d dose. Progression-free survival and median survival times during the entire period of the study were 9.5 and 28.5 months, respectively. Treatment-related toxicities were generally mild, the most common being skin disorders and diarrhoea. Only one case experienced grade 3 toxicity, which was transient increase of hepatic enzymes. CONCLUSION The primary end-point was not met; low-dose erlotinib is not recommended for fit patients with NSCLC harbouring EGFR mutations. However, it may merit further evaluation for elderly or frail patients.
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Affiliation(s)
- Kazuhiko Yamada
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan.
| | - Hiromi Aono
- Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Terufumi Kato
- Division of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-City Seibu Hospital, Kanagawa, Japan
| | - Masanori Nishikawa
- Department of Respiratory Medicine, Fujisawa City Hospital, Kanagawa, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroaki Takeoka
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yoshiro Nakahara
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan; Department of Respiratory Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Akira Sato
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Mari S Oba
- Department of Biostatistics, Yokohama City University Medical Center, Kanagawa, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hideo Kunitoh
- Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan; Department of Medical Oncology, Japanese Red Cross Medical Center, Tokyo, Japan
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Komase Y, Asako A, Kobayashi A, Sharma R. Ease-of-use preference for the ELLIPTA® dry powder inhaler over a commonly used single-dose capsule dry powder inhaler by inhalation device-naïve Japanese volunteers aged 40 years or older. Int J Chron Obstruct Pulmon Dis 2014; 9:1365-75. [PMID: 25525354 PMCID: PMC4267517 DOI: 10.2147/copd.s72762] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In patients receiving inhaled medication, dissatisfaction with and difficulty in using the inhaler can affect treatment adherence. The incidence of handling errors is typically higher in the elderly than in younger people. The aim of the study was to assess inhaler preference for and handling errors with the ELLIPTA® dry powder inhaler (DPI), (GSK), compared with the established BREEZHALER™, a single-dose capsule DPI (Novartis), in inhalation device-naïve Japanese volunteers aged ≥40 years. METHODS In this open-label, nondrug interventional, crossover DPI preference study comparing the ELLIPTA DPI and BREEZHALER, 150 subjects were randomized to handle the ELLIPTA or BREEZHALER DPIs until the point of inhalation, without receiving verbal or demonstrative instruction (first attempt). Subjects then crossed over to the other inhaler. Preference was assessed using a self-completed questionnaire. Inhaler handling was assessed by a trained assessor using a checklist. Subjects did not inhale any medication in the study, so efficacy and safety were not measured. RESULTS The ELLIPTA DPI was preferred to the BREEZHALER by 89% of subjects (odds ratio [OR] 70.14, 95% confidence interval [CI] 33.69-146.01; P-value not applicable for this inhaler) for ease of use, by 63% of subjects (OR 2.98, CI 1.87-4.77; P<0.0001) for ease of determining the number of doses remaining in the inhaler, by 91% for number of steps required, and by 93% for time needed for handling the inhaler. The BREEZHALER was preferred to the ELLIPTA DPI for comfort of the mouthpiece by 64% of subjects (OR 3.16, CI 1.97-5.06; P<0.0001). The incidence of handling errors (first attempt) was 11% with ELLIPTA and 68% with BREEZHALER; differences in incidence were generally similar when analyzed by age (< or ≥65 years) or sex. CONCLUSION These data, obtained in an inhalation device-naïve population, suggest that the ELLIPTA DPI is preferred to an established alternative based on its ease-of-use features and is associated with fewer handling errors.
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Affiliation(s)
- Yuko Komase
- Department of Respiratory Internal Medicine, St Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan
| | - Akimoto Asako
- MA Respiratory Department, Development and Medical Affairs Unit, GlaxoSmithKline KK, Tokyo, Japan
| | - Akihiro Kobayashi
- Biomedical Data Sciences Department, GlaxoSmithKline KK, Tokyo, Japan
| | - Raj Sharma
- Global Respiratory Franchise Medical Department, GSK, Stockley Park, UK
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Abstract
OBJECTIVE To investigate the influence of dry mouth on the incidence and severity of inhalation therapy-induced hoarseness. METHODS The volume of saliva secreted without stimulation was measured in patients with asthma or chronic obstructive pulmonary disease (COPD) who also answered a questionnaire on subjective ratings for hoarseness. The relationship between salivary secretion and hoarseness was analyzed by the Pearson correlation and multiple linear regression. The prediction accuracy of salivary secretion for the grade of hoarseness was evaluated using a receiver-operating characteristic (ROC) analysis. RESULTS A total of 232 patients participated in this study. The subjective rating score of hoarseness was negatively correlated with the volume of saliva secreted (r = -0.273, p < 0.001). A stepwise multiple linear regression analysis revealed that salivary secretion (p < 0.001) and the dose of fluticasone administered (p < 0.05) were significant variables for predicting hoarseness. The ROC analysis for predicting severe hoarseness by salivary secretion showed significant prediction accuracy (AUC = 0.690, 95% CI: 0.614-0.766, p < 0.001) and was higher in patients administered fluticasone (AUC = 0.732, 95% CI: 0.644-0.821, p < 0.001). CONCLUSIONS Hyposalivation is a significant prediction factor of hoarseness induced by inhaled corticosteroids (ICS). The prediction accuracy was higher in patients administered fluticasone than in those administered another inhalation drug. Although the pharmaceutical efficacy of fluticasone is high, patients with hyposalivation should be prescribed other inhalation drugs.
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Affiliation(s)
- Daiki Hira
- Department of Pharmacy, Shiga University of Medical Science Hospital , Seta Tsukinowa-cho, Otsu, Shiga , Japan
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Nakahara Y, Hosomi Y, Yamada K, Okamoto H, Kato T, Komase Y, Nishikawa M, Morita S, Kunitoh H, Watanabe K. A prospective, multicenter phase II trial of low-dose erlotinib monotherapy for patients with previously treated non-small cell lung cancer (NSCLC) with activating mutation of epidermal growth factor receptor (EGFR): Thoracic Oncology Research Group (TORG) 0911. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.8080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yoshiro Nakahara
- Department of Thoracic Oncology and Respiratory Medecine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medecine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | | | - Terufumi Kato
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Yuko Komase
- St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | | | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideo Kunitoh
- Division of Chemotherapy, Department of Internal Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
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Yoshimura C, Momose Y, Horie T, Komase Y, Niimi A, Dobashi K, Fujimoto K, Tohda Y, Ohta K, Adachi M. [Current status of "hospital-clinic" and "hospital-pharmacy" cooperation for inhalation therapy -based on hospital surveys throughout Japan]. Arerugi 2014; 63:178-186. [PMID: 24714183] [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] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 02/03/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND The "zero death from asthma strategy" in the medical treatment for bronchial asthma has been promoted by the Ministry of Health, Labour, and Welfare from 2006, and it indicates that medical and non-medical specialists, as well as pharmacists, should cooperate, and strives to build cooperation which is suited the actual conditions of an area. It is also important for COPD. Although hospitals in some areas cooperate with clinics and pharmacies, the overall concept of cooperation appears to be absent in most Japanese hospitals. METHOD A questionnaire was administered in early March, 2012 to 477 allergology institutions, and was authorized by an educational establishment. RESULT Among 246 replies from the institutions, cooperation between hospitals and clinics was carried out by 98 institutions (39.8%) specializing in bronchial asthma, and in 64 institutions (37.2%) specializing in COPD. However, cooperation tools were used in only 37 of these institutions (15.0%). The ability to fill prescriptions outside the hospital was available in 209 institutions (85.0%). One-hundred and seventeen institutions (47.6%) replied that they have no tools for hospital-pharmacy cooperation. Direct indications were written in prescriptions by 82 institutions (33.3). CONCLUSION In order to build inter-regional association and to equalize medical treatment, we suggest that developing tools and organization for cooperation between health professionals who treat patients with bronchial asthma and COPD is necessary.
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Affiliation(s)
- Chie Yoshimura
- Respiratory Medicine, Osaka Red Cross Hospital, Osaka, Japan
| | - Yasuyuki Momose
- School of Pharmaceutial Sciences International University of Health and Welfare
| | - Takeo Horie
- Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Gumma
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-city Seibu Hospital
| | - Akio Niimi
- Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences
| | | | - Keisaku Fujimoto
- Departments of Clinical Laboratory Sciences, Shinshu University School of Health Sciences
| | - Yuuji Tohda
- The Department of Respiratory Medicine and Allergology, Kinki University, Faculty of Medicine
| | - Ken Ohta
- National Hospital Organization, Tokyo National Hospital
| | - Mitsuru Adachi
- International University of Health and Welfare, Clinical Medicine Study Center Department of Allergy, Sanno Hospital
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35
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Yamaguchi H, Komase Y, Ono A, Morita A, Ishida A. Successful treatment with noninvasive positive-pressure ventilation based on the prediction of disease onset using CT and respiratory function tests in an elderly patient with relapsing polychondritis. Intern Med 2013; 52:1085-9. [PMID: 23676595 DOI: 10.2169/internalmedicine.52.9035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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
An 83-year-old man who had been receiving treatment for bronchial asthma since 62 years of age experienced difficulty breathing on exertion and was admitted to the hospital. On admission, computed tomography revealed tracheal wall thickening, while test results for antinuclear antibodies and anti-type II collagen antibodies were positive. Since a saddle nose deformity, malacia of the auricles and sensorineural deafness were also observed, relapsing polychondritis was diagnosed. Measuring the peak expiratory flow rate was useful in the early airway assessment. During the follow-up period, the patient's dyspnea worsened and noninvasive positive-pressure ventilation was introduced. As a result, the subjective symptoms improved.
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Affiliation(s)
- Hiromichi Yamaguchi
- Department of Respiratory Medicine, Yokohama-City Seibu Hospital of St. Marianna University School of Medicine, Japan.
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Komase Y, Ishida A, Morita A, Yamaguchi H, Iwata M, Kawakami C. [A case of severe influenza (H1N1) 2009 virus pneumonia identified by virus culture instead of PCR]. ACTA ACUST UNITED AC 2012; 85:670-3. [PMID: 22250459 DOI: 10.11150/kansenshogakuzasshi.85.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A 70-year-old man was being treated for asthma and chronic obstructive pulmonary disease, which had been well controlled. He was seen at our emergency outpatient department on October 24, 2009, for respiratory distress and mild fever. Point-of-care testing for influenza, general bacteria, and acid-fast bacilli in the sputum, were negative. With antibiotics ineffective, his respiratory status worsened, requiring him to be intubated and ventilated mechanically. Steroid pulse therapy temporarily improved his condition, as confirmed by imaging studies, but he died on hospital day 38. Polymerase chain reaction (PCR) analysis of tracheal secretion and bronchial washings collected on hospital day 14 and 21 were negative for influenza (H1N1) 2009 virus, which was identified in a subsequent culture. Negative results for reverse transcriptase-PCR analysis leave (H1N1) 2009 virus unable to be diagnosed clinically. Culture tests and repeated PCR analysis have been done in cases of strongly suspected clinical infection to confirm results. Our case, in which the virus was identified by culture, suggests that the viral load may have been too low or the time of culture inappropriate.
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Affiliation(s)
- Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University, School of Medicine, Yokohama-City Seibu Hospital
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37
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Fukutomi Y, Taniguchi M, Watanabe J, Nakamura H, Komase Y, Ohta K, Akasawa A, Nakagawa T, Miyamoto T, Akiyama K. Time trend in the prevalence of adult asthma in Japan: findings from population-based surveys in Fujieda City in 1985, 1999, and 2006. Allergol Int 2011; 60:443-8. [PMID: 21593576 DOI: 10.2332/allergolint.10-oa-0282] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [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: 10/16/2010] [Accepted: 01/21/2011] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The burden of asthma is recognized as an important public health problem worldwide. In most countries, the prevalence of asthma has been reported to increase in the last few decades. However, more recent epidemiological studies have shown that the prevalence of asthma has been flat or even decreasing after the 1990 s in some developed countries. The recent time trend in the prevalence of adult asthma in Japan is unknown. METHODS Population-based surveys were conducted three times in the same region, in 1985, 1999, and 2006, at Fujieda City, Shizuoka, Japan, and the results were reported previously. We compared the results of these surveys to reveal the time trend in the prevalence of adult asthma. Although the questionnaires used in these surveys were not exactly the same, the time trend was assessed by comparing the responses to relevant questions between questionnaires. RESULTS The prevalences of wheeze following a common cold and dyspneal feeling at night increased significantly from 1985 to 1999 (4.2% to 7.6%, and 3.2% to 5.3%, respectively). The prevalences of lifetime asthma and current asthma also significantly increased from 1999 to 2006 (5.1% to 6.7%, and 1.5% to 3.4%, respectively). CONCLUSIONS The prevalences of asthma among adults in Fujieda City consistently increased from 1985 to 2006. There was no evidence that the prevalences were in plateau or decreasing. These findings suggest that more efforts are required to stop the increase in the burden of this disease in Japan.
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Affiliation(s)
- Yuma Fukutomi
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
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38
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Yamaguchi H, Higashi N, Mita H, Ono E, Komase Y, Nakagawa T, Miyazawa T, Akiyama K, Taniguchi M. Urinary concentrations of 15-epimer of lipoxin A(4) are lower in patients with aspirin-intolerant compared with aspirin-tolerant asthma. Clin Exp Allergy 2011; 41:1711-8. [PMID: 22093074 DOI: 10.1111/j.1365-2222.2011.03839.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 05/05/2011] [Accepted: 06/22/2011] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although an abnormality in arachidonic acid metabolism may be responsible for aspirin-intolerant asthma (AIA), there is little knowledge about the concentrations of urinary lipoxin A(4) (LXA(4)) and the 15-epimer of LXA(4) (15-epi-LXA(4)) in relation to asthma severity in AIA subjects. OBJECTIVE The purpose of this study is to estimate urinary LXA(4) and the 15-epimer concentrations to investigate lipoxins in AIA. METHODS In this study, we examined AIA, aspirin-tolerant asthma (ATA) and healthy control groups. The AIA and ATA groups were subdivided into the severe asthma and non-severe asthma subgroups. Urinary LXA(4), 15-epi-LXA(4) and leukotriene E(4) (LTE(4) ) were quantified using enzyme immunoassay after separating these compounds using high-performance liquid chromatography. RESULTS The urinary LXA(4) concentration was significantly lower than the 15-epi-LXA(4) concentration in the asthmatic subjects. The AIA group showed significantly lower urinary 15-epi-LXA(4) (P < 0.01) and higher urinary LTE(4) concentrations (P < 0.05) than the ATA group. Comparison of 15-epi-LXA(4) concentrations between the severe asthmatic and non-severe asthmatic subjects in the AIA and ATA groups revealed that the decreased 15-epi-LXA(4) concentration may be related to aspirin intolerance, but not asthma severity. Receiver operator characteristic curves demonstrated that the concentration ratio of LTE(4) to 15-epi-LXA(4) was superior to 15-epi-LXA(4) concentration and LTE(4) concentration as a predictive factor for aspirin intolerance. CONCLUSIONS AND CLINICAL RELEVANCE We have demonstrated for the first time that urinary 15-epi-LXA(4) concentration is significantly higher than LXA(4) concentration in both the AIA and ATA groups. 15-Epi-LXA(4) concentration was significantly lower in the AIA group with an increased urinary LTE(4) concentration than in the ATA group. An imbalance between proinflammatory cysteinyl-leukotrienes and anti-inflammatory 15-epi-LXA(4) may be involved in AIA pathogenesis.
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Affiliation(s)
- H Yamaguchi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
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39
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Sakaida H, Komase Y, Takemura T. Organizing pneumonia in a patient with rheumatoid arthritis treated with etanercept. Mod Rheumatol 2010; 20:611-6. [PMID: 20585825 DOI: 10.1007/s10165-010-0327-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Accepted: 05/31/2010] [Indexed: 12/26/2022]
Abstract
Etanercept-induced organizing pneumonia (OP) has not been reported in Japan. We describe the case of a rheumatoid arthritis patient who developed OP during etanercept treatment and discuss the possible mechanisms underlying the development of etanercept-induced OP and the existence of factors that predispose Japanese patients to drug-induced OP.
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Affiliation(s)
- Hiroyuki Sakaida
- Odoriba Sakaida Clinic, 8-2-1 Gumisawa-cho, Totsuka-ku, Yokohama, 245-0061, Japan.
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Fukutomi Y, Nakamura H, Kobayashi F, Taniguchi M, Konno S, Nishimura M, Kawagishi Y, Watanabe J, Komase Y, Akamatsu Y, Okada C, Tanimoto Y, Takahashi K, Kimura T, Eboshida A, Hirota R, Ikei J, Odajima H, Nakagawa T, Akasawa A, Akiyama K. Nationwide cross-sectional population-based study on the prevalences of asthma and asthma symptoms among Japanese adults. Int Arch Allergy Immunol 2010; 153:280-7. [PMID: 20484927 DOI: 10.1159/000314369] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Accepted: 01/07/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Asthma is a common respiratory disease worldwide. However, few reports are available on the prevalences of asthma and asthma symptoms among Asian subjects. METHODS To determine the prevalences of asthma and asthma symptoms among Japanese subjects, we performed a nationwide cross-sectional, population-based study on Japanese adults aged 20-79 years. Ten areas spread throughout the country were randomly selected. Door-to-door or postal surveys were performed using a translated version of the European Community Respiratory Health Survey questionnaire. RESULTS The survey was completed by 23,483 participants. The overall response rate was 70.6%. The prevalences of wheeze and current asthma among all participants aged 20-79 years were 10.1% (95% CI: 9.7-10.5%) and 4.2% (95% CI: 4.0-4.5%), respectively. The prevalences among young adults aged 20-44 years were 9.3% (95% CI: 8.7-9.9%) and 5.3% (95% CI: 4.8-5.8%), respectively. The prevalence of current asthma was highest in females aged 30-39 years in comparison with the other gender and age groups. CONCLUSIONS This nationwide study determined the prevalences of asthma and asthma symptoms among Japanese adults. The results provide fundamental information on the respiratory health of Japanese adults.
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Affiliation(s)
- Yuma Fukutomi
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.
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Yamaguchi H, Komase Y, Ikehara M, Yamamoto T, Shinagawa T. Disseminated cryptococcal infection with eosinophilia in a healthy person. J Infect Chemother 2008; 14:319-24. [PMID: 18709538 DOI: 10.1007/s10156-008-0618-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 04/25/2008] [Indexed: 11/30/2022]
Abstract
A 23-year-old man with no recent medical history was hospitalized complaining of high fever and cough. In addition to very marked eosinophilia, chest X-ray revealed extensive bronchovascular bundle thickening. Transbronchial lung biopsy (TBLB) showed moderate eosinophil infiltration. Cryptococcus neoformans infection was diagnosed, based on blood culture, cerebrospinal fluid culture, urine culture, and lung biopsy specimens. The eosinophilia was successfully alleviated by treatment for cryptococcal meningitis. Furthermore, cryptococcal sepsis resolved with amphotericin B and 5-flucytosine treatment. Eosinophilia commonly occurs following chronic Aspergillus infection, but the present case suggests the involvement of Cryptococcus in another mechanism for eosinophilia.
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Affiliation(s)
- Hiromichi Yamaguchi
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-city Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama 241-0811, Japan.
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Ikehara M, Yamaguchi H, Yamamoto T, Komase Y, Sano F, Shinagawa T. [Case of pulmonary MALT lymphoma with follow-up imaging for 10 years]. Nihon Kokyuki Gakkai Zasshi 2008; 46:146-151. [PMID: 18318260] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Although abnormal shadow in the left upper lung of an 84-year-old male patient was confirmed in an examination in November 1996, follow-up observation was discontinued. In July 2006, he first visited our department with a chief complaint of shortness of breath, and was hospitalized because of an abnormal shadow in the left upper lung field and left pleural effusion. Since atypical lymphocytes were found in the pleural effusion, and positive cellular surface markers CD19 and 20, and chromosomal aberration of t (11 ; 18) (q22 ; q21) were confirmed, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) was diagnosed. Transbronchial lung biopsy of the left upper lobe confirmed small lymphocyte-like cellular infiltration, as seen in the pleural effusion, and CD20 immunostaining was positive, leading to the diagnosis of MALT lymphoma. In addition, serum immunoelectrophoresis demonstrated the development of macroglobulinemia as a complication. This case is valuable as changes diagnostic image over 10 years can be compared.
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MESH Headings
- Aged, 80 and over
- Antigens, CD19/analysis
- Antigens, CD20/analysis
- Biomarkers, Tumor/analysis
- Diagnosis, Differential
- Follow-Up Studies
- Humans
- Immunoelectrophoresis
- Lung Neoplasms/complications
- Lung Neoplasms/diagnosis
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Male
- Time Factors
- Tomography, X-Ray Computed
- Waldenstrom Macroglobulinemia/complications
- Waldenstrom Macroglobulinemia/diagnosis
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Affiliation(s)
- Mizuki Ikehara
- Department of Respiratory Medicine, St. Marianna University Yokohama Seibu Hospital
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Komase Y, Abe T, Kasahara K, Kaneko T, Takahashi H, Nishikawa M, Kuwahira I. Survey on the handling of chronic obstructive pulmonary disease by annual health check in Japan. Intern Med 2008; 47:1791-6. [PMID: 18854630 DOI: 10.2169/internalmedicine.47.1006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
OBJECTIVE Since mild COPD can be detected in the annual health check by lung function tests, we conducted a questionnaire survey on how such examinations are used to assess chronic obstructive pulmonary disease (COPD). METHODS We mailed questionnaires to 633 facilities performing comprehensive medical check-up from June to July 2005 and obtained responses from 254 (40.1%). RESULTS At participating facilities, the proportion of full or part-time physicians specializing in respiratory diseases was low [40 of 366 full timers (10.9%) and 114 of 2,044 part-timers (5.6%)], with very few physicians certified by the Japanese Respiratory Society (6.8%). Non respiratory physicians were involved in evaluating the results of thoracic diagnostic imaging at 32 facilities. Lung function tests were carried out at 98.2% of facilities though relatively few facilities evaluated test results with COPD in mind. All stages (mild, moderate, severe) of COPD were diagnosed in patients at 85 facilities (39.2%), while only severe COPD was targeted by chest imaging at 97 facilities (44.7%), disregarding mild and moderate cases. Counseling for smoking cessation was provided at 113 facilities (20.6%), while 30 facilities (14.4%) provided no form of smoking cessation. CONCLUSION At most facilities performing a comprehensive medical check-up, there was not a sufficient number of respirologists to ensure early diagnosis of COPD and this may have compromised COPD diagnosis. The newly proposed Japan Society of Comprehensive Medical Check-up (Ningen-dock) Standards based on the Japanese Respiratory Society may be useful to reveal early stages of COPD.
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Affiliation(s)
- Yuko Komase
- St. Marianna University School of Medicine, Yokohama-City Seibu Hospital, Yokohama.
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Komase Y, Kunishima H, Yamaguchi H, Ikehara M, Yamamoto T, Shinagawa T. Rapidly progressive invasive pulmonary aspergillosis in a diabetic man. J Infect Chemother 2007; 13:46-50. [PMID: 17334729 DOI: 10.1007/s10156-006-0481-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 06/09/2006] [Accepted: 10/02/2006] [Indexed: 11/28/2022]
Abstract
A 45-year-old man was admitted to our hospital with high fever and a large amount of gray sputum. His initial chest X-ray showed broncho-bronchiolitis and thickening of the large bronchus, and he was subsequently diagnosed with pulmonary aspergillosis based on his sputum culture, polymerase chain reaction for Aspergillus fumigatus, and mannan antigen for Aspergillus. His immune responses, including neutrophil phagocytosis function and neutrophil sterilizing function, were normal as far as we could determine. He was treated with itraconazole, amphotericin B, and meropenem trihydrate, but died of respiratory failure on the twenty-fifth hospital day. Chest X-ray showed rapidly progressive invasive shadows in both lung fields, resulting in multiple cavity formation. This was a rare case of invasive pulmonary aspergillosis in a diabetic man with normal neutrophil phagocytosis function and neutrophil sterilizing function.
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Affiliation(s)
- Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-city Seibu Hospital, Yokohama, Japan, Yokohama, Kanagawa 241-0811, Japan.
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Saito H, Ikehara M, Komase Y, Omiya S, Nakagawa T. [A case of sub-acute onset pulmonary sarcoidosis with pulmonary dysfunction]. Nihon Kokyuki Gakkai Zasshi 2005; 43:225-30. [PMID: 15966369] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A 60-year-old man was admitted to our hospital because of shortness of breath and dry cough. Slight pleural thickening was observed on the chest X-ray film and chest CT on presenting. Three months later, bilateral hilar lymphadenopathy and multiple small nodular shadows were shown in both lung fields by chest CT. Serum ACE level and lysozyme levels were higher than normal upper limit. Elevation of CRP and left shift of leukocytes were not detected. Restrictive ventilatory impairment was shown in the respiratory function test. This case was diagnosed as sarcoidosis most probably with histological evidence of epithelioid cell granulomas in the lung tissue obtained by transbronchial lung biopsy. After prednisolone medication (40 mg per day) was started, symptoms, pulmonary function and chest CT findings improved. Our case was considered to be a rare case of pulmonary sarcoidosis with subacute onset of symptoms and restrictive pulmonary function abnormality which improved smoothly as a result of steroid therapy.
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Affiliation(s)
- Hiroo Saito
- Department of Respiratory Medicine, Yokohama-city Seibu Hospital St. Marianna University, School of Medicine
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Komase Y. [Diagnostic tests and advances in their methods. 3. Histamine release test]. ACTA ACUST UNITED AC 2005; 93:2108-15. [PMID: 15552910 DOI: 10.2169/naika.93.2108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Nakagawa T, Komase Y, Ikezawa Z, Aihara M, Iwasaki E, Okubo K, Hasegawa M, Akiyama K, Miyamoto T. [Evaluation of MAST-26, newly developed system for the detection of IgE antibodies]. Arerugi 2000; 49:335-44. [PMID: 10824399] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
MAST-26 is a new allergy testing system which allows simultaneous determination of allergen-specific IgE antibody levels for 26 allergens using 200 microliters of patient serum. To evaluate the effectiveness of MAST-26 for the detection of allergen-specific IgE antibody, a total of 100 serum samples were collected from allergic patients at five facilities, and allergen-specific IgE antibody was measured by MAST-26. 14% of them were positive to > or = 10 allergens. If the patients had severe allergic symptoms, they were likely to show positive to many allergens. A good correlation was found between the results obtained by MAST-26 with those measured by CAP RAST and by intradermal skin test. It was concluded that MAST-26 is an effective screening method for the detection of allergen-specific IgE.
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Affiliation(s)
- T Nakagawa
- Dept. of Internal Medicine, St. Marianna University School of Medicine
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Komase Y, Itop S, Kobayashi M, Nakagawa T. A case of anaphylactoid reaction due to Matsutake mushroom (Tricoloma matsutake) ingestion. Allergol Int 1999. [DOI: 10.1046/j.1440-1592.1999.00148.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Komase Y, Sakata M, Azuma T, Tanaka A, Nakagawa T. IgE antibodies against midge and moth found in Japanese asthmatic subjects and comparison of allergenicity between these insects. Allergy 1997; 52:75-81. [PMID: 9062632 DOI: 10.1111/j.1398-9995.1997.tb02548.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The specific IgE antibodies to moth (Bombyx mori) and midge (Chironomus yoshimatsui) were measured by the Pharmacia CAP system in 51 house-dust-mite-sensitive asthma patients. None of these patients had definite histories of exposure to these insects or apparent evidence of insect-induced asthma symptoms. The RAST-inhibition assay was performed to investigate cross-allergenicity between these two insects. Furthermore, IgE immunoblotting was done to study the IgE-binding components in moth and midge extracts. Thirty (59%) of these patients showed positive IgE antibodies to moth, while 25 (49%) showed positive IgE antibodies to midge. Those frequencies of positivity were similar to that for Japanese cedar pollen, which is well known to cause allergy. A significant correlation (r = 0.863) was observed between IgE antibody titers of these two insects. The results from the RAST-inhibition assay indicated cross-allergenicity between these insects and also the existence of species-specific allergens. Fifteen IgE-binding components in moth extract were observed. The most frequent IgE-binding protein was the 79-kDa (84.2%), followed by the 72-kDa (78.9%), the 82-kDa (57.9%), and the 76-kDa (57.9%) proteins. Those were considered to be major allergens in moth. Twenty-four IgE-binding components in midge extract were observed. However, no IgE-binding protein to which over 50% of patient sera reacted was observed. These results suggest that these two insects may be considered to bear important allergens and that there is cross-allergenicity between these insects as well as species-specific allergens.
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Affiliation(s)
- Y Komase
- First Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan
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