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Murakawa Y, Dobashi H, Kondo M, Nishiyama S, Okazaki R, Hasegawa Y, Moriyama M, Sugiura T, Onishi I, Honda M, Nagamura N, Yoshioka Y, Minamoto T. Questionnaire survey on the prevention and development of cervical cancer in patients with systemic lupus erythematosus in Japan. Mod Rheumatol 2024; 34:352-358. [PMID: 36929382 DOI: 10.1093/mr/road028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES The aim is to evaluate the prevention and development of cervical cancer in systemic lupus erythematosus (SLE) patients in Japan and its background based on a questionnaire survey. METHODS The questionnaire was handed to 460 adult female SLE patients at 12 medical institutions. The participants were grouped by age, and data related to their human papillomavirus vaccination status, age at first coitus, cervical cancer screening, and diagnosis of cervical cancer were analysed. RESULTS A total of 320 responses were received. Patients aged 35-54 years included a higher proportion of patients whose age at first coitus was <20 years. This group also showed a higher rate of cervical cancer/dysplasia. Only nine patients had a human papillomavirus vaccination history. Adequate frequency of cervical cancer screening was slightly higher (52.1%) among SLE patients than in the Japanese general population. However, 23% of the patients had never undergone examination, primarily because of a feeling of troublesome. The incidence of cervical cancer was significantly higher among SLE patients. One reason for this may be associated with the use of immunosuppressants, although the difference was not significant. CONCLUSIONS SLE patients are at a higher risk of cervical cancer and dysplasia. Rheumatologists should proactively recommend vaccination and screening examinations for SLE female patients.
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Affiliation(s)
- Yohko Murakawa
- Department of Internal Medicine III, Shimane University, Izumo, Japan
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Japan
- Department of Rheumatology, Tamatsukuri Hospital, Matsue, Japan
| | - Hiroaki Dobashi
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Masahiro Kondo
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Japan
- National Hospital Organization Hamada Medical Center, Hamada, Japan
- Division of Rheumatology, Masuda Medical Association Hospital, Masuda, Japan
| | - Susumu Nishiyama
- Rheumatic Disease Center, Kurashiki Medical center, Kurashiki, Japan
| | - Ryota Okazaki
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yasuyuki Hasegawa
- Department of Rheumatology, Tottori Prefecture Central Hospital, Tottori, Japan
| | - Mayuko Moriyama
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Japan
- Division of Rheumatology, Oda Municipal Hospital, Oda, Japan
| | - Tomoko Sugiura
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Japan
- Sugiura Clnic, Izumo, Japan
| | | | - Manabu Honda
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Japan
- Division of Rheumatology, Oda Municipal Hospital, Oda, Japan
| | - Norihiro Nagamura
- Department of Allergy & Rheumatology, Shimane Central Hospital, Izumo, Japan
| | - Yuki Yoshioka
- Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Japan
| | - Toshiko Minamoto
- Department of Gynecology, Faculty of Medicine Shimane University, Izumo, Japan
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Nagamura N, Sugitani T. A case of ureteral stenosis due to ureteritis probably associated with rheumatoid arthritis. Mod Rheumatol Case Rep 2023; 7:335-339. [PMID: 36508304 DOI: 10.1093/mrcr/rxac071] [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: 03/25/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 06/21/2023]
Abstract
Ureteritis associated with the immunological disorder is rarely reported, and most cases in this category are small vessel vasculitis and immunoglobulin G4-related disease. Rheumatoid arthritis (RA)-associated ureteritis is uncommon, and underlying aetiology is unclear. We present a patient with ureteritis who had a medical history of RA and was successfully treated with steroids and immunosuppressant. A 49-year-old woman who had been treated for RA and atopic dermatitis suffered from gross haematuria for 5 successive days. Contrast-enhanced computed tomography (CT) showed right-dominant upper urinary tract dilatation with enhanced thickened wall. The haematuria continued accompanied with intermittent right back and lower abdominal pain, and the following CT image taken after 3 months presented the progression to bilateral hydronephrosis. Ureteral stents were placed, and antibiotic therapy was introduced for obstructive pyelonephritis. Ureterocystoscopy and following biopsy from the upper ureteral tract showed a chronic inflammatory change in the histopathology, and we finally considered the stenosing ureteritis to be caused by immune-mediated mechanism related to RA. After starting steroid therapy with methotrexate, therapeutic response was obtained to remove the stents. In the cases of ureteritis or ureteral stenosis of unknown aetiology with a medical history of immunological disorders, we should consider the underlying immune-activated state and try to test contrast-enhanced CT and histological examination before performing a surgical procedure. After excluding the common causes of ureteritis or ureteral stenosis, these tests would support the appropriate diagnosis.
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Affiliation(s)
- Norihiro Nagamura
- Department of Rheumatology and Allergology, Shimane Prefectural Central Hospital, Izumo, Shimane, Japan
| | - Tomoyuki Sugitani
- Department of Urology, Shimane Prefectural Central Hospital, Izumo, Shimane, Japan
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Nagamura N, Imada T. Anti-interferon-gamma autoantibody related disseminated nontuberculous mycobacteriosis with pathological features of immunoglobulin G4-related disease. Immunol Med 2021; 45:48-53. [PMID: 34033731 DOI: 10.1080/25785826.2021.1914962] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
A 72-year-old man who was diagnosed as pulmonary mycobacterium avium complex (MAC) disease had suffered from antibiotics resistant fever with left renal enlargement surrounded by inflammatory change and multiple osteolytic lesions on computed tomography (CT). The renal biopsied samples pathologically showed immunoglobulin G4 (IgG4) positive plasma cell infiltration and many acid-fast bacilli without granuloma formation. Nucleic acid identification test for MAC from the samples of vertebral osteolytic lesion was positive. In the autopsy samples from left kidney, epithelioid cell granuloma and Langhans giant cell with many acid-fast bacilli were shown pathologically. In addition to osteolytic lesions on CT study, these pathological findings were not consistent with IgG4-related disease (IgG4-RD). The diagnosis of disseminated nontuberculous mycobacteriosis was made, and plasma anti-interferon-gamma (IFN-γ) autoantibody was found as the cause of underlying immunodeficiency. Disturbed function of IFN-γ resulted in impaired ability of phagocytic cells against pathogens and leading to spread of infection. T-helper type 2 dominant immune response was induced by prolonged antigenic stimulation of mycobacteria, which might have contributed to form the pathological features of IgG4-RD.
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Affiliation(s)
- Norihiro Nagamura
- Department of Rheumatology and Allergology, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Toshihiro Imada
- Department of General Medicine, Shimane Prefectural Central Hospital, Izumo, Japan
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Kawamoto H, Higashitarumizu N, Nagamura N, Nakamura M, Shimamura K, Ohashi N, Nagashio K. Micrometer-scale monolayer SnS growth by physical vapor deposition. Nanoscale 2020; 12:23274-23281. [PMID: 33206097 DOI: 10.1039/d0nr06022d] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Recently, monolayer SnS, a two-dimensional group IV monochalcogenide, was grown on a mica substrate at the micrometer-size scale by the simple physical vapor deposition (PVD), resulting in the successful demonstration of its in-plane room temperature ferroelectricity. However, the reason behind the monolayer growth remains unclear because it had been considered that the SnS growth inevitably results in a multilayer thickness due to the strong interlayer interaction arising from lone pair electrons. Here, we investigate the PVD growth of monolayer SnS from two different feed powders, highly purified SnS and commercial phase-impure SnS. Contrary to expectations, it is suggested that the mica substrate surface is modified by sulfur evaporated from the Sn2S3 contaminant in the as-purchased powder and the lateral growth of monolayer SnS is facilitated due to the enhanced surface diffusion of SnS precursor molecules, unlike the growth from the highly purified powder. This insight provides a guide to identify further controllable growth conditions.
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Affiliation(s)
- H Kawamoto
- Department of Materials Engineering, The University of Tokyo, Tokyo 113-8656, Japan.
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Nagamura N, Fukiwake N, Ozasa R. Steroid Resistant Hypereosinophilic Syndrome Suspected to Be Caused by Aberrant T-cell Subset. Kurume Med J 2020; 65:185-191. [PMID: 31723076 DOI: 10.2739/kurumemedj.ms654003] [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] [Indexed: 11/23/2022]
Abstract
A 53-year-old male presented with cough, skin rash and lymphadenopathies complicated with hypereosinophilia (HE) in the blood, and patchy shadows in both lungs on chest computed tomography. Reactive causes for HE were excluded, and no clinical or laboratory features of myeloproliferative disorders could be found. HE caused by aberrant T-cell subsets was suspected because of serum hyper-immunoglobulin E level, and organ involvement of skin and lungs, though we could show neither aberrant T-cell surface markers nor T-cell receptor gene rearrangement. In the course of steroid monotherapy, tolerable maintenance dose could not be attained and the steroid-sparing agents of hydroxycarbamide, cyclosporine and interferon-α were introduced. However, the therapeutic response was inadequate, and organ involvement of lungs and intestinal tract developed. HE caused by aberrant T-cell subsets has steroid resistance and a risk of malignant transition, and we considered this progressive steroid refractoriness to be a sign of such a transition. Cytotoxic chemotherapy or bone marrow transplantation will likely be the next treatment modality in this patient.
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Affiliation(s)
- Norihiro Nagamura
- Department of Rheumatology and Allergy, Shimane Prefectural Central Hospital
| | - Noriko Fukiwake
- Department of General Medicine, Shimane Prefectural Central Hospital
| | - Ryotaro Ozasa
- Department of General Medicine, Shimane Prefectural Central Hospital
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Nagamura N, Higuchi H. Segmental Arterial Mediolysis with Preceding Symptoms Resembling Viral Infection Hampers the Differentiation from Polyarteritis Nodosa. Intern Med 2019; 58:2721-2726. [PMID: 31527370 PMCID: PMC6794176 DOI: 10.2169/internalmedicine.2487-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A middle-aged man presented with a fever, arthralgia, gastrointestinal symptoms, headache, and rash. After two weeks, the patient suddenly complained of severe abdominal pain, and computed tomography revealed aneurysms in the hepatic and splenic arteries, which increased in size progressively. Given the elevated levels of inflammatory markers and orchitis, polyarteritis nodosa (PN) was initially suspected. Catheter embolization for the ruptured hepatic aneurysm and splenectomy for the large splenic ones were performed, and the pathological finding was consistent with segmental arterial mediolysis (SAM). Changes in inflammatory marker levels and aneurysmal size are also informative to differentiate SAM from PN.
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Affiliation(s)
- Norihiro Nagamura
- Department of Rheumatology and Allergology, Shimane Prefectural Central Hospital, Japan
| | - Hiroshi Higuchi
- Department of General Medicine, Shimane Prefectural Central Hospital, Japan
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Nagamura N, Kin S. Scleroderma renal crisis during intravenous cyclophosphamide pulse therapy for complicated interstitial lung disease was successfully treated with angiotensin converting enzyme inhibitor and plasma exchange. Nagoya J Med Sci 2016; 78:329-34. [PMID: 27578917 PMCID: PMC4995279] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Systemic sclerosis (SSc) is a multiorgan disorder involving the skin, heart, lungs, kidneys, and intestines. Progressive interstitial lung disease (ILD) is a serious complication in SSc patients, and cyclophosphamide (CYC) is the only recommended therapy for this condition;(1)) however, its clinical effectiveness is not sufficient. Scleroderma renal crisis (SRC) is a rare complication, characterized by acute renal failure and progressive hypertension. Angiotensin-converting-enzyme inhibitor (ACE-i) is a widely accepted therapy for SRC. We report an SSc patient with SRC and progressive ILD who underwent treatment with CYC and successful treatment with ACE-i and plasma exchange (PE). SRC and ILD are significant contributors to morbidity and mortality among SSc patients, and the therapy for these disorders is of great interest to rheumatologists. This study presents the possibility of favorable effects of PE for SSc-associated ILD and SRC.
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Affiliation(s)
- Norihiro Nagamura
- 1Department of Rheumatology and Allergy, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Seikon Kin
- Department of Nephrology, Shimane Prefectural Central Hospital, Izumo, Japan
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Nagamura N, Ueno S, Fujishiro H, Oonuma H. Hepatitis associated with hypereosinophilia suspected to be caused by HES that also presented with the pathological features of IgG4-related disease. Intern Med 2014; 53:145-9. [PMID: 24429456 DOI: 10.2169/internalmedicine.53.0292] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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
A 52-year-old woman presented to our hospital due to elevated liver enzyme levels and hypereosinophilia. Liver biopsy specimens revealed chronic hepatitis with abundant eosinophils and immunoglobulin G4(IgG4)-positive plasma cell infiltration. Systemic lymphadenopathy, including that involving the hepatic hilar lymph nodes, was observed on computed tomography, and the cervical lymph node biopsy specimens exhibited lymphoid follicular hyperplasia and IgG4-positive plasma cell infiltration. It is sometimes difficult to distinguish hypereosinophilic syndrome (HES) from IgG4-related disease, as some of the clinical findings overlap. The numerous areas of eosinophilic infiltration observed in the liver indicated a diagnosis of HES in our case.
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Affiliation(s)
- Norihiro Nagamura
- Department of Rheumatology and Allergy, Shimane Prefectural Central Hospital, Japan
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Horiba K, Nakamura Y, Nagamura N, Toyoda S, Kumigashira H, Oshima M, Amemiya K, Senba Y, Ohashi H. Scanning photoelectron microscope for nanoscale three-dimensional spatial-resolved electron spectroscopy for chemical analysis. Rev Sci Instrum 2011; 82:113701. [PMID: 22128978 DOI: 10.1063/1.3657156] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In order to achieve nondestructive observation of the three-dimensional spatially resolved electronic structure of solids, we have developed a scanning photoelectron microscope system with the capability of depth profiling in electron spectroscopy for chemical analysis (ESCA). We call this system 3D nano-ESCA. For focusing the x-ray, a Fresnel zone plate with a diameter of 200 μm and an outermost zone width of 35 nm is used. In order to obtain the angular dependence of the photoelectron spectra for the depth-profile analysis without rotating the sample, we adopted a modified VG Scienta R3000 analyzer with an acceptance angle of 60° as a high-resolution angle-resolved electron spectrometer. The system has been installed at the University-of-Tokyo Materials Science Outstation beamline, BL07LSU, at SPring-8. From the results of the line-scan profiles of the poly-Si/high-k gate patterns, we achieved a total spatial resolution better than 70 nm. The capability of our system for pinpoint depth-profile analysis and high-resolution chemical state analysis is demonstrated.
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Affiliation(s)
- K Horiba
- Department of Applied Chemistry, The University of Tokyo, Tokyo 113-8656, Japan.
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Nagamura N, Andou M, Toyokawa T, Ohnisi T, Nakatu M, Suwaki K, Hirohata M. [Primary liver carcinoid tumor complicated with colon cancer]. ACTA ACUST UNITED AC 2007; 96:1473-5. [PMID: 17682436 DOI: 10.2169/naika.96.1473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kanaji N, Bandoh S, Nagamura N, Kushida Y, Haba R, Ishida T. Significance of an epidermal growth factor receptor mutation in cerebrospinal fluid for carcinomatous meningitis. Intern Med 2007; 46:1651-5. [PMID: 17917328 DOI: 10.2169/internalmedicine.46.0335] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report a case of epidermal growth factor receptor (EGFR) inhibitor-sensitive lung adenocarcinoma with carcinomatous meningitis who showed a good response to gefitinib, an oral tyrosine kinase inhibitor of EGFR. This good response to gefitinib treatment was attributed to evidence of an EGFR mutation, L858R in exon 21, which was detected in a small amount of cerebrospinal fluid (CSF) before the positive CSF cytology. Patients with carcinomatous meningitis often have a poor performance status, and therefore diagnostic approaches and therapeutic methods are also often limited. Detection of EGFR mutations may be a useful method for non-small cell lung cancer diagnosis, and also facilitate determination of appropriate therapeutic protocols.
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Affiliation(s)
- Nobuhiro Kanaji
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University.
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Nagamura N, Iwahara S. [Multivariate analysis of electroencephalography during sleep in human]. Shinrigaku Kenkyu 1969; 40:12-23. [PMID: 5818092 DOI: 10.4992/jjpsy.40.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
The cortical potentials (EEG) of the albino rat were studied from birth to maturity. For several days after birth the EEG recordings were mostly flat with occasional appearance of 6 to 12 c/s waves of low voltage. After 5 days a long sequence of highly rhythmic waves of the same frequencies was most characteristic, often synchronous with the respiratory cycle and even after gross bodily movement. Frequency of these rhythms increased to 14 to 18 c/s at 14 days. High-voltage slow waves during behavioral sleep appeared after 7 days from birth and sleep spindles were shown after 20 days. The “activated sleep” pattern was identified and the typical features of the adult EEG were nearly complete from 20 to 30 days of age.
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Nakamura K, Nagamura N, Iwahara S. [Physio-psychological study on sleep, with special reference to the electroenephalogram]. Shinrigaku Kenkyu 1968; 39:137-54. [PMID: 4303424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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