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Jinno M, Ohta S, Mikuni H, Uno T, Uchida Y, Manabe R, Miyata Y, Homma T, Watanabe Y, Kusumoto S, Suzuki S, Tanaka A, Sagara H. Involvement of Muscarinic M3 Receptor in the Development of M2 Macrophages in Allergic Inflammation. Int Arch Allergy Immunol 2024:1-10. [PMID: 38565078 DOI: 10.1159/000538126] [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: 07/28/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION The muscarinic M3 receptor antagonist, tiotropium, has a bronchodilatory effect on asthma patients. Additionally, tiotropium inhibits allergic airway inflammation and remodeling in a murine asthma model. However, the underlying mechanisms of this M3 receptor antagonist remain unclear. Therefore, we investigated the effect of muscarinic M3 receptor blockage on M2 macrophage development during allergic airway inflammation. METHODS BALB/c mice were sensitized and challenged with ovalbumin to develop a murine model of allergic airway inflammation mimicking human atopic asthma. During the challenge phase, mice were treated with or without tiotropium. Lung cells were isolated 24 h after the last treatment and gated using CD68-positive cells. Relm-α and Arginase-1 (Arg1) (M2 macrophage markers) expression was determined by flow cytometry. Mouse bone marrow mononuclear cell-derived macrophages (mBMMacs) and human peripheral blood mononuclear cells (PBMCs)-derived macrophages were stimulated with IL-4 and treated with a muscarinic M3 receptor antagonist in vitro. RESULTS The total cells, eosinophils, and IL-5 and IL-13 levels in BAL fluids were markedly decreased in the asthma group treated with tiotropium compared to that in the untreated asthma group. The Relm-α and Arg1 expression in macrophages was reduced considerably in the asthma group treated with tiotropium compared to that in the untreated asthma group, suggesting that the development of M2 macrophages was inhibited by muscarinic M3 receptor blockage. Additionally, muscarinic M3 receptor blockage in vitro significantly inhibited M2 macrophage development in both mBMMacs- and PBMCs-derived macrophages. CONCLUSIONS Muscarinic M3 receptor blockage inhibits M2 macrophage development and prevents allergic airway inflammation. Moreover, muscarinic M3 receptors might be involved in the differentiation of immature macrophages into M2 macrophages.
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Affiliation(s)
- Megumi Jinno
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Shin Ohta
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Hatsuko Mikuni
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Tomoki Uno
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Yoshitaka Uchida
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Ryo Manabe
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Yoshito Miyata
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Tetsuya Homma
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Yoshio Watanabe
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Sojiro Kusumoto
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Shintaro Suzuki
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Akihiko Tanaka
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
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Tanaka Y, Ota R, Hirata A, Yokoyama S, Nakagawa C, Uno T, Hosomi K. Effect of baseline urinary glucose levels on the relationship between sodium-glucose cotransporter 2 inhibitors and serum uric acid in Japanese patients with type 2 diabetes mellitus. Pharmazie 2023; 78:238-244. [PMID: 38178282 DOI: 10.1691/ph.2023.3602] [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: 01/06/2024]
Abstract
In patients with type 2 diabetes mellitus (T2DM), controlling serum uric acid (SUA) and blood glucose levels is important. Moreover, sodium-glucose cotransporter 2 (SGLT2) inhibitors decrease SUA levels by accelerating urinary uric acid excretion. We investigated the effect of baseline urinary glucose levels on the relationship between SGLT2 inhibitors and SUA levels. We conducted a retrospective observational study using the electronic medical records of patients with T2DM of Kindai University Nara Hospital (April 2013 to March 2022). We divided the patients into two groups according to their baseline urinary glucose levels: the N-UG group, which included patients with negative urinary glucose strip test results (-), and the P-UG group, which included patients with positive urinary glucose strip test results (± or more). The changes in SUA levels before and after SGLT2 inhibitor administration were investigated. For comparison, the changes in SUA levels before and after the prescription of antidiabetic agents, excluding SGLT2 inhibitors, were also investigated. Our results revealed that SGLT2 inhibitors significantly decreased the SUA levels in patients in the N-UG group but tended to decrease its levels in those in the P-UG group. Regardless of the urinary glucose status at baseline, the administration of SGLT2 inhibitors may be useful for patients with T2DM to prevent the complications of hyperuricemia.
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Affiliation(s)
- Y Tanaka
- Division of Drug Informatics, School of Pharmacy, Kindai University, Osaka; Department of Pharmacy , Kindai University Nara Hospital, Nara, Japan
| | - R Ota
- Department of Pharmacy, Kindai University Nara Hospital, Nara, Japan
| | - A Hirata
- Department of Pharmacy, Kindai University Nara Hospital, Nara, Japan
| | - S Yokoyama
- Division of Drug Informatics, School of Pharmacy, Kindai University, Osaka
| | - C Nakagawa
- Division of Drug Informatics, School of Pharmacy, Kindai University, Osaka; Department of Pharmacy , Kindai University Nara Hospital, Nara, Japan
| | - T Uno
- Division of Drug Informatics, School of Pharmacy, Kindai University, Osaka
| | - K Hosomi
- Division of Drug Informatics, School of Pharmacy, Kindai University, Osaka
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Hirai K, Tanaka A, Oda N, Kaneko K, Uchida Y, Uno T, Ohta S, Homma T, Yamaguchi F, Suzuki S, Sagara H. Prevalence and Impact of Social Frailty in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:2117-2126. [PMID: 37780032 PMCID: PMC10541088 DOI: 10.2147/copd.s418071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/17/2023] [Indexed: 10/03/2023] Open
Abstract
Background Patients with chronic obstructive pulmonary disease (COPD) are more inclined to have a high level of social vulnerability due to their physical and psychological burden. However, to date, there have been no study on social frailty in patients with COPD. This study aimed to investigate the prevalence, characteristics, and impact of social frailty in patients with COPD. Methods Social frailty was assessed using five items in a questionnaire. A patient was diagnosed with social frailty if responses to two or more items were positive. Four hundred and five patients with COPD were assessed for social frailty, dyspnea, and appetite. We also prospectively examined the number of acute exacerbation and unexpected hospitalization for 1 year. Results Thirty-six percent of patients with COPD had social frailty. They had reduced appetite and more severe dyspnea [Simplified Nutritional Appetite Questionnaire score: odds ratio (OR) 0.81, 95% confidence interval (CI) 0.69‒0.95, p < 0.01; modified Medical Research Council score: OR 1.42, 95% CI 1.05‒1.93, P = 0.02] than patients without social frailty. Social frailty was not a risk factor for moderate acute exacerbation of COPD but a risk factor for severe acute exacerbation and all-cause unexpected hospitalization (severe acute exacerbation: β, standardized regression coefficient: 0.13, 95% CI 0.01‒0.25, P = 0.04, unexpected hospitalization: β 0.17, 95% CI 0.05‒0.29, P = 0.01). Conclusion The prevalence of social frailty is 36%; however, social frailty has a marked clinical impact in patients with COPD.
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Affiliation(s)
- Kuniaki Hirai
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Tanaka
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Naruhito Oda
- Department of Medicine, Division of Respiratory Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan
| | - Keisuke Kaneko
- Department of Medicine, Division of Respiratory Medicine, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan
| | - Yoshitaka Uchida
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Homma
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Fumihiro Yamaguchi
- Department of Medicine, Division of Respiratory Medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Shintaro Suzuki
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
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Kazahari N, Inoue E, Nakagawa N, Kawamoto Y, Uno T, Inoue-Murayama M. Genetic effects of demographic bottleneck and recovery in Kinkazan Island and mainland populations of Japanese macaques (Macaca fuscata). Primates 2023; 64:239-246. [PMID: 36806706 DOI: 10.1007/s10329-023-01050-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 01/12/2023] [Indexed: 02/23/2023]
Abstract
Populations of Japanese macaques were significantly reduced in most areas from the 1900s to the 1960s and then recovered mainly in the northeastern part of Honshu. A drastic reduction in population size reduces genetic variability through a bottleneck effect. Demographic expansion after the reduction that accumulates new mutations can reduce the bottleneck effects or drive the recovery of genetic variability. We examined the genetic status of a small island population (Kinkazan Island) and a larger mainland population (southern Tohoku) of Japanese macaques that experienced recent demographic bottlenecks and recovery using eight microsatellite loci. The two populations were significantly genetically different from each other. The Kinkazan population exhibited lower genetic variability, remarkable evidence of bottleneck (i.e., significant heterozygosity excess and lower frequency of rare alleles), and a considerably smaller effective population size based on genetic data than based on the current census size. These results indicate that the genetic status has not completely recovered from the demographic bottleneck despite a full recovery in census size on Kinkazan Island. New mutations might rarely have accumulated because of the small carrying capacity of the island. Therefore, the genetic variability of the population would have been restrained by the severe bottleneck size, small carrying capacity, and long-term isolation. On the other hand, the bottleneck effect seems to be limited in the southern Tohoku population considering higher genetic variability, non-significant heterozygosity excess in many mutation conditions, and the highest frequency of rare alleles.
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Affiliation(s)
- N Kazahari
- Wildlife Research Center, Kyoto University, 2-24 Tanaka-Sekiden-cho, Sakyo, Kyoto, 606-8203, Japan.
- Field Science Center for Northern Biosphere, Hokkaido University, Sapporo, Japan.
| | - E Inoue
- Faculty of Science, Toho University, Chiba, Japan
| | - N Nakagawa
- Graduate School of Science, Kyoto University, Kyoto, Japan
| | - Y Kawamoto
- Primate Research Institute, Kyoto University, Inuyama, Japan
- Laboratory of Wildlife Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - T Uno
- Tohoku, Monkey and Mammal Management Center, Sendai, Japan
| | - M Inoue-Murayama
- Wildlife Research Center, Kyoto University, 2-24 Tanaka-Sekiden-cho, Sakyo, Kyoto, 606-8203, Japan
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Kimura T, Suzuki S, Kumaki R, Kishimoto K, Uno T, Nojo M, Shimamura M, Iwazumi E, Tanaka A, Sagara H. [SURVEY OF KNOWLEDGE ABOUT ANAPHYLAXIS AND GUIDANCE WHEN DISPENSING EPIPEN FOR PHARMACISTS WORKING IN PHARMACIES]. Arerugi 2023; 72:453-462. [PMID: 37460287 DOI: 10.15036/arerugi.72.453] [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/PURPOSE Anaphylactic shock is a serious and life-threatening condition, and affected patients should be quickly and effectively treated with an EpiPen. Although the correct use of an EpiPen is greatly affected by a user's proficiency level and the instructions accompanying the EpiPen, there has been almost no investigation into the knowledge of the EpiPen and the actual situation of the accompanying instructions for use. Therefore, we conducted this nationwide survey to elucidate these issues. METHODS A questionnaire survey was conducted among pharmacists registered as members of the system of a research company outside the university and working at pharmacies with experience in handling EpiPen prescriptions. RESULTS Many of the pharmacists surveyed knew that the EpiPen is the first-line treatment for anaphylactic shock. However, they did not have sufficient knowledge of administration routes and candidates for second-line treatment. Both their occasions and experiences of dealing of EpiPen were found to be low. CONSIDERATION It is desirable to learn at conferences regarding allergology/clinical allergy and seminars for medical professionals including pharmacists in order to acquire the skills and knowledge to consult with patients with allergic diseases, including action plans presented by doctors in preparation for recurrence of anaphylaxis.
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Affiliation(s)
- Tomoyuki Kimura
- Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University
| | - Shintaro Suzuki
- Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University
| | - Ryota Kumaki
- Division of Social Pharmacy, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University
| | - Keiko Kishimoto
- Division of Social Pharmacy, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University
| | - Tomoki Uno
- Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University
| | - Makoto Nojo
- Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University
| | - Miri Shimamura
- Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University
| | - Eriko Iwazumi
- Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University
| | - Akihiko Tanaka
- Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University
| | - Hironori Sagara
- Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University
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Akutsu A, Horikoshi T, Yokota H, Wada T, Motoori K, Nasu K, Yamasaki K, Hanazawa T, Ikeda JI, Uno T. MR Imaging Findings of Carcinoma Ex Pleomorphic Adenoma Related to Extracapsular Invasion and Prognosis. AJNR Am J Neuroradiol 2022; 43:1639-1645. [PMID: 36202554 PMCID: PMC9731259 DOI: 10.3174/ajnr.a7656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE MR imaging can reflect the pathologic progression of carcinoma ex pleomorphic adenoma (CXPA). This study aimed to identify the imaging findings related to extracapsular invasion of CXPA. Additionally, the pathologic background of these findings was investigated. MATERIALS AND METHODS This retrospective study included 37 patients with histologically confirmed CXPA. Three radiologists independently evaluated whether the CXPA showed the following characteristic MR imaging findings: border, capsule, the corona sign on fat-saturated T2WI and contrast-enhanced fat-saturated T1WI, and the black ring sign. The corona sign appeared larger on fat-saturated and/or contrast-enhanced fat-saturated T1WI than on T1WI. The black ring sign was defined as an intratumoral nodule with a thick low-intensity rim on T2WI. Interreader agreement of the visual assessment was performed using κ analysis, and MR imaging and histopathologic findings were also correlated. Kaplan-Meier survival and the log-rank test were used to estimate the 3-year disease-free survival. RESULTS MR imaging findings, especially peritumoral findings, showed a significant difference between invasive and noninvasive CXPA. The reliability was poor for the border and capsule. In contrast, it was good for the corona sign on fat-saturated and contrast-enhanced fat-saturated T1WI and the black ring sign. Pathologically, the corona sign reflected the invasiveness of the tumor and inflammatory cells, while the black ring sign reflected hyalinization or fibrosis. The corona sign also showed a significant difference in the 3-year disease-free survival. CONCLUSIONS MR imaging findings, including the corona and black ring signs, reliably differentiated invasive and noninvasive CXPA. The corona sign can be used as a prognostic factor for CXPA.
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Affiliation(s)
- A Akutsu
- From the Department of Radiology (A.A., T.H., T.W., K.N.), Chiba University Hospital, Chiba, Japan
| | - T Horikoshi
- From the Department of Radiology (A.A., T.H., T.W., K.N.), Chiba University Hospital, Chiba, Japan
| | - H Yokota
- Diagnostic Radiology and Radiation Oncology (H.Y., T.U.)
| | - T Wada
- From the Department of Radiology (A.A., T.H., T.W., K.N.), Chiba University Hospital, Chiba, Japan
| | - K Motoori
- Department of Radiology (K.M.), Tsudanuma Central General Hospital, Chiba Narashino-shi Yatsu, Japan
| | - K Nasu
- From the Department of Radiology (A.A., T.H., T.W., K.N.), Chiba University Hospital, Chiba, Japan
| | - K Yamasaki
- Otorhinolaryngology, Head and Neck Surgery (K.Y., T.H.), Graduate School of Medicine, Chiba University, Chiba, Japan
| | - T Hanazawa
- Otorhinolaryngology, Head and Neck Surgery (K.Y., T.H.), Graduate School of Medicine, Chiba University, Chiba, Japan
| | - J-I Ikeda
- Departments of Diagnostic Pathology (J.-I.I.)
| | - T Uno
- Diagnostic Radiology and Radiation Oncology (H.Y., T.U.)
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Shimokawa K, Matsumoto K, Yokota H, Kobayashi E, Hirano Y, Masuda Y, Uno T. Anxiety relaxation during MRI with a patient-friendly audiovisual system. Radiography (Lond) 2022; 28:725-731. [PMID: 35428571 DOI: 10.1016/j.radi.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/31/2021] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Many patients experience anxiety, not limited to claustrophobia, before magnetic resonance imaging (MRI) examination. We performed a non-randomized controlled trial to evaluate whether a patient-friendly audiovisual (AV) system in the MR scanner room reduces patient anxiety. METHODS We randomly selected 61 participants from outpatients who required brain MRI examination. Patients were informed that they could choose to undergo an MRI examination with a patient-friendly AV system (Ambient Experience, Philips Healthcare, Best, The Netherlands) or the standard system. To complete the MRI examination without affecting clinical practice, all patients who preferred the patient-friendly AV system were assigned to the preferring AV group. Patients who indicated that either system was acceptable were randomly assigned to the no preference but allocated AV group or control (using the standard system) groups. In both groups, state anxiety using the State-Trait Anxiety Inventory (STAI) was assessed before and after the MRI examination (A-State-before and A-State-after MRI, respectively). The changes in A-State-before and A-State-after MRI were categorized as follows: relieved high-state anxiety, no change in high-state anxiety, stable easiness, and intensified anxiety. RESULTS Among the 61 included patients, 19 were assigned to the preferring AV group, 20 to the no preference but allocated AV group, and 22 to the control group. There were no significant differences between the group. However, in patients with high-state anxiety before MRI, the preferring AV group and the no preference but allocated AV group, which used the patient-friendly AV system, relieved high-state anxiety by 63.6% (7 of 11 patients) and 81.8% (9 of 11 patients), respectively. In contrast, the control group using the standard system relieved high-level anxiety by only 42.9% (three out of seven patients). CONCLUSION The patient-friendly AV system may reduce anxiety in patients undergoing MRI examinations. IMPLICATIONS FOR PRACTICE The patient-friendly AV system may reduce anxiety in patients undergoing MRI examination by providing a more patient-centered MRI examination environment. These findings may help ameliorate negative perceptions associated with MRI examination.
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Affiliation(s)
- K Shimokawa
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan.
| | - K Matsumoto
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan.
| | - H Yokota
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan.
| | - E Kobayashi
- Department of Neurosurgery, National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakihara, Chuo-ku, Chiba-shi, Chiba 260-8606, Japan.
| | - Y Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-0856, Japan.
| | - Y Masuda
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan.
| | - T Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan.
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Hirai K, Tanaka A, Homma T, Kawahara T, Oda N, Mikuni H, Uchida Y, Saito H, Fukuda Y, Fujiwara A, Sato Y, Uno T, Inoue H, Ohta S, Yamaguchi F, Suzuki S, Ohnishi T, Sagara H. Characteristics of and reasons for patients with chronic obstructive pulmonary disease to continue smoking, quit smoking, and switch to heated tobacco products. Tob Induc Dis 2021; 19:85. [PMID: 34786018 PMCID: PMC8562318 DOI: 10.18332/tid/142848] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/25/2021] [Accepted: 10/04/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking is the leading cause of chronic obstructive pulmonary disease (COPD), and smoking cessation is the most effective treatment for patients with COPD. However, few studies have investigated the continuation/cessation of smoking and heated tobacco products (HTP) in patients with COPD. The objective of this study was to examine the characteristics of patients with COPD, those who are current smokers and those who switched from cigarettes to HTP, and to examine the reason for the continuation or cessation of smoking. METHODS This multicenter, cross-sectional study included 411 outpatients with COPD. Data for this study were part of a study conducted for a comprehensive evaluation of the smoking status and clinical factors in patients with COPD and their families. RESULTS Logistic regression analysis revealed that a younger age, longer duration of smoking, fewer daily cigarettes, and lower modified Medical Research Council (mMRC) dyspnea score, and a lower Simplified Nutritional Appetite Questionnaire (SNAQ) score for appetite, were characteristics of current smokers (age OR=0.94; duration of smoking OR=1.07; number of cigarettes per day OR=0.94; mMRC OR=0.68; SNAQ OR=0.83; p<0.05). The logistic regression analysis model showed that a younger age and higher education level were associated with the use of HTP (age OR=0.83; higher education level OR=4.63; p<0.05). Many of the current smokers displayed smoking behaviors that are not guaranteed to be safe, such as reducing smoking or switching to lighter cigarettes or HTP. CONCLUSIONS Patients with COPD who continue smoking tended to have low appetite as well as smoking behaviors that are not guaranteed to be safe. Physicians should provide appropriate guidance to these patients on smoking cessation.
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Affiliation(s)
- Kuniaki Hirai
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Tanaka
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Homma
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tomoko Kawahara
- Division of Respiratory Medicine, Department of Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan
| | - Naruhito Oda
- Division of Respiratory Medicine, Department of Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan
| | - Hatsuko Mikuni
- Division of Respiratory Medicine, Department of Medicine, Kokuho Asahi Chuo Hospital, Chiba, Japan
| | - Yoshitaka Uchida
- Division of Respiratory Medicine, Department of Medicine, Kokuho Asahi Chuo Hospital, Chiba, Japan
| | - Haruhisa Saito
- Division of Respiratory Medicine, Department of Medicine, Kokuho Asahi Chuo Hospital, Chiba, Japan
| | - Yosuke Fukuda
- Division of Respiratory Medicine, Department of Medicine, Ebara Hospital, Tokyo, Japan
| | - Akiko Fujiwara
- Division of Respiratory Medicine, Department of Medicine, Odawara Municipal Hospital, Odawara, Japan
| | - Yoko Sato
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hideki Inoue
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Fumihiro Yamaguchi
- Division of Respiratory Medicine, Department of Medicine, Showa University Fujigaoka Hospital, Fujigaoka, Japan
| | - Shintaro Suzuki
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tsukasa Ohnishi
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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Inoue H, Akimoto K, Ikeda H, Sato H, Uno T, Uchida Y, Kawahara T, Fukuda Y, Hirai K, Miyata Y, Homma T, Ohta S, Yamamoto M, Suzuki S, Tanaka A, Sagara H. Comprehensive Gene Expression Signature Using RNA-Seq in Airways of Mouse Model of Severe Asthma with Fungal Sensitization. Int Arch Allergy Immunol 2021; 183:142-152. [PMID: 34587616 DOI: 10.1159/000519172] [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] [Received: 06/21/2021] [Accepted: 08/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Inhalation of fungal allergens induces airway epithelial damage following airway inflammation and excessive mucus secretion, which can lead to severe asthma with fungal sensitization (SAFS). Comprehensive gene expression analysis in Alternaria-exposed mouse airways, a model of SAFS, has not been conducted. METHODS BALB/c mice received intranasal administration of Alternaria extract or phosphate-buffered saline twice a week for 6 weeks. Lung sections and bronchoalveolar lavage fluid were obtained to assess airway inflammation. RNA-Seq in the central airway was performed, and gene ontology (GO) analysis and gene set enrichment analysis (GSEA) were conducted for pathway analyses. An in vitro experiment using human airway epithelial cell 16HBE14o- was performed to validate the RNA-Seq findings. RESULTS Eosinophilic airway inflammation with mucus overproduction and airway remodeling was observed in mice exposed to Alternaria. RNA-Seq analysis revealed 403 upregulated and 108 downregulated genes in airways of Alternaria-exposed mice. In GO analysis, the functions of immunoglobulin (Ig) receptor binding, Ig production, inflammatory response, and T-cell activation were upregulated, while those of keratinization and defense response to other organisms were downregulated. GSEA revealed positive enrichment in T-cell receptor complex, immunological synapse, antigen binding, mast cell activation, and Ig receptor binding, and negative enrichment in keratinization and cornification in Alternaria-exposed mice relative to control. Alternaria exposure to 16HBE14o- cells validated the downregulation of epithelial keratinization-related genes, including SPRR1A, SPRR1B, and KRT6B. CONCLUSION RNA-Seq analysis showed that Alternaria exposure induced inflammatory response and impaired defense mechanisms in mice airway epithelium, which might be therapeutic targets for SAFS.
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Affiliation(s)
- Hideki Inoue
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Kaho Akimoto
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Hitoshi Ikeda
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Hiroki Sato
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Tomoki Uno
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Yoshitaka Uchida
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Tomoko Kawahara
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Yosuke Fukuda
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Kuniaki Hirai
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Yoshito Miyata
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Tetsuya Homma
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Shin Ohta
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Mayumi Yamamoto
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Shintaro Suzuki
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Akihiko Tanaka
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Hironori Sagara
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan
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11
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Hirai K, Tanaka A, Homma T, Goto Y, Akimoto K, Uno T, Yoshitaka U, Miyata Y, Inoue H, Ohta S, Suzuki S, Sagara H. Serum creatinine/cystatin C ratio as a surrogate marker for sarcopenia in patients with chronic obstructive pulmonary disease. Clin Nutr 2021; 40:1274-1280. [DOI: 10.1016/j.clnu.2020.08.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 12/31/2022]
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12
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Funakoshi H, Momo K, Okazaki K, Ebato T, Yamamoto S, Uno T, Ohta S, Sagara H, Sasaki T. β 2 -adrenoceptor agonist inhalation induced paroxysmal atrial fibrillation and tachycardia in a patient with severe bronchial asthma. Br J Clin Pharmacol 2021; 87:3375-3377. [PMID: 33567472 DOI: 10.1111/bcp.14741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/29/2020] [Accepted: 01/09/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Haruki Funakoshi
- Department of Pharmacy, Showa University Hospital, Tokyo, Japan.,Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan
| | - Kenji Momo
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan
| | - Keinosuke Okazaki
- Department of Pharmacy, Showa University Hospital, Tokyo, Japan.,Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan
| | - Takaya Ebato
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shigenori Yamamoto
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tadanori Sasaki
- Department of Pharmacy, Showa University Hospital, Tokyo, Japan.,Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan
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13
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Fukuda Y, Homma T, Uno T, Murata Y, Suzuki S, Shiozawa E, Takimoto M, Sagara H. Fatal rupture of pulmonary artery pseudoaneurysm after thoracic radiation therapy against lung squamous cell carcinoma: A case report and literature review. Clin Case Rep 2021; 9:737-741. [PMID: 33598236 PMCID: PMC7869342 DOI: 10.1002/ccr3.3647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/18/2020] [Revised: 11/14/2020] [Accepted: 11/24/2020] [Indexed: 01/01/2023] Open
Abstract
Pulmonary artery pseudoaneurysm is a rare but fatal condition. It has been associated with lung cancer, abscesses, and radiation therapy. Identification in patients with hemoptysis is critical, and timely interventional therapy is warranted.
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Affiliation(s)
- Yosuke Fukuda
- Department of MedicineDivision of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
| | - Tetsuya Homma
- Department of MedicineDivision of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
| | - Tomoki Uno
- Department of MedicineDivision of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
| | - Yasunori Murata
- Department of MedicineDivision of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
| | - Shintaro Suzuki
- Department of MedicineDivision of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
| | - Eisuke Shiozawa
- Department of PathologyShowa University School of MedicineTokyoJapan
| | - Masafumi Takimoto
- Department of PathologyShowa University School of MedicineTokyoJapan
| | - Hironori Sagara
- Department of MedicineDivision of Respiratory Medicine and AllergologyShowa University School of MedicineTokyoJapan
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14
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Hirai K, Tanaka A, Homma T, Kawahara T, Oda N, Mikuni H, Uchida Y, Saito H, Kaneko K, Fujiwara A, Goto Y, Uno T, Miyata Y, Ohta S, Yamaguchi F, Suzuki S, Ohnishi T, Sagara H. Investigating Patient and Family Satisfaction with the Respiratory Status in Patients with Chronic Obstructive Pulmonary Disease. COPD 2021; 18:83-90. [PMID: 33504227 DOI: 10.1080/15412555.2021.1874898] [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: 10/22/2022]
Abstract
The current chronic obstructive pulmonary disease (COPD) management aims to improve the patients' quality of life and healthy life expectancy; however, few studies have evaluated the level of satisfaction with the patients' current respiratory status in COPD patients and their families. This study aimed to examine the level of patient and family satisfaction with the patients' current respiratory status and to identify the clinical factors closely linked to dissatisfaction.This multicenter, cross-sectional study included 454 outpatients with COPD and 296 family members. Patients and families were allocated to the satisfied and dissatisfied groups based on their satisfaction with the patients' current respiratory status. Patients' health status, dyspnoea, appetite, respiratory function, and mood disorders were assessed.Among the participants of this study, 67% of patients and 60% of their families were dissatisfied with the patients' current respiratory status. The COPD assessment test (CAT) was the most sensitive marker of dissatisfaction compared to other clinical factors (p < 0.01). The statistical cut-off value of CAT for predicting patient dissatisfaction was 11. CAT reflected patient dissatisfaction independent of age, sex, dyspnoea, appetite, mood disorders, body mass index, and respiratory function (odds ratio: CAT; 1.12 (1.07-1.19): p < 0.01).Many patients and families are dissatisfied with the patients' respiratory status, and the patients' CAT score is useful to predict dissatisfaction. Our findings are consistent with the Global Initiative for Chronic Obstructive Lung Disease indicating that treatment should be enhanced in patients with a CAT score ≥10. Furthermore, treatment strategies targeting CAT may contribute to an improved patient satisfaction.
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Affiliation(s)
- Kuniaki Hirai
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Tanaka
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Homma
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoko Kawahara
- Department of Medicine, Division of Respiratory Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan
| | - Naruhito Oda
- Department of Medicine, Division of Respiratory Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan
| | - Hatsuko Mikuni
- Department of Medicine, Division of Respiratory Medicine, Kokuho Asahi Chuo Hospital, Chiba, Japan
| | - Yoshitaka Uchida
- Department of Medicine, Division of Respiratory Medicine, Kokuho Asahi Chuo Hospital, Chiba, Japan
| | - Haruhisa Saito
- Department of Medicine, Division of Respiratory Medicine, Kokuho Asahi Chuo Hospital, Chiba, Japan
| | - Keisuke Kaneko
- Department of Medicine, Division of Respiratory Medicine, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan
| | - Akiko Fujiwara
- Department of Medicine, Division of Respiratory Medicine, Odawara Municipal Hospital, Odawara, Kanagawa, Japan
| | - Yuiko Goto
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Yoshito Miyata
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Fumihiro Yamaguchi
- Department of Medicine, Division of Respiratory Medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Shintaro Suzuki
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tsukasa Ohnishi
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
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15
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Fukuda Y, Tanaka A, Homma T, Kaneko K, Uno T, Fujiwara A, Uchida Y, Suzuki S, Kotani T, Sagara H. Utility of SpO2/FiO2 ratio for acute hypoxemic respiratory failure with bilateral opacities in the ICU. PLoS One 2021; 16:e0245927. [PMID: 33493229 PMCID: PMC7833145 DOI: 10.1371/journal.pone.0245927] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/08/2021] [Indexed: 11/18/2022] Open
Abstract
Acute hypoxemic respiratory failure (AHRF) with bilateral opacities causes fatalities in the intensive care unit (ICU). It is often difficult to identify the causes of AHRF at the time of admission. The SpO2 to FiO2 (S/F) ratio has been recently used as a non-invasive and alternative marker of the PaO2/FiO2 (P/F) ratio in acute respiratory failure. This retrospective cohort study was conducted from October 2010 to March 2019 at the Showa University Hospital, Tokyo, Japan. We enrolled 94 AHRF patients who had bilateral opacities and received mechanical ventilation in ICU to investigate their prognostic markers including S/F ratio. Significant differences were observed for APACHE II, S/F ratio, PaO2/FiO2 (P/F) ratio, and ventilator-free-days at day 28 for ICU mortality, and for age, S/F ratio, P/F ratio, duration of mechanical ventilation, and ventilator-free days at day 28 for hospital mortality. Multivariate logistic regression analysis showed that the S/F ratio was significantly and independently associated with the risk of death during in ICU (p = 0.003) and hospitalization (p = 0.002). The area under the receiver operating characteristic curves (AUC) based on the S/F ratio were significantly greater than those based on simplified acute physiology score (SAPS) II and sequential organ failure assessment (SOFA) for ICU mortality (0.785 in S/F ratio vs. 0.575 in SAPS II, p = 0.012; 0.785 in S/F ratio vs 0.594 in SOFA, p = 0.021) and for hospital mortality (0.701 in S/F ratio vs. 0.502 in SAPS II, p = 0.012; 0.701 in S/F ratio vs. 0.503 in SOFA, p = 0.005). In the subanalysis for bacterial pneumonia and interstitial lung disease groups, the AUC based on the S/F ratio was the greatest among all prognostic markers, including APACHE II, SAPS II, and SOFA. The S/F ratio may be a useful and noninvasive predictive prognostic marker for acute hypoxemic respiratory failure with bilateral opacities in the ICU.
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Affiliation(s)
- Yosuke Fukuda
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Akihiko Tanaka
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Tetsuya Homma
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Keisuke Kaneko
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Tomoki Uno
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Akiko Fujiwara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Yoshitaka Uchida
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Shintaro Suzuki
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Toru Kotani
- Department of Intensive Care Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
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16
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Akimoto K, Hirai K, Matsunaga T, Kaneko K, Mikuni H, Kawahara T, Uno T, Fujiwara A, Miyata Y, Ohta S, Homma T, Inoue H, Yamaguchi F, Kusumoto S, Suzuki S, Tanaka A, Sagara H. The Relationship Between the "Adherence Starts with Knowledge-20" Questionnaire and Clinical Factors in Patients with COPD: A Multi-Center, Cross-Sectional Study. Int J Chron Obstruct Pulmon Dis 2020; 15:3201-3211. [PMID: 33311977 PMCID: PMC7726831 DOI: 10.2147/copd.s280464] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/16/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose Inhaler therapy is the mainstay of chronic obstructive pulmonary disease (COPD) management. Poor adherence causes disease exacerbation and affects patient mortality. Although the Adherence Starts with Knowledge-20 (ASK-20) questionnaire is a reliable tool for assessing medication adherence, the relationship between the ASK-20 and clinical factors in patients with COPD remains unknown. We investigated the relationship between the ASK-20 and clinical factors, and assessed real-world inhaler therapy use. Patients and Methods A multicenter, cross-sectional study of outpatients with COPD undergoing inhaler treatment who completed the ASK-20 questionnaire was performed. We investigated COPD-related health status using the COPD Assessment Test (CAT), psychological status using the Hospital Anxiety and Depression Scale (HADS-anxiety and HADS-depression), respiratory function, patient satisfaction levels, and real-world inhaler therapy use. Results Of the total 319 patients, 87% were male with a median age of 74 years. Most patients had mild or moderate COPD, according to Global Initiative for Chronic Obstructive Lung Disease stage. The total ASK-20 scores correlated significantly with the CAT, HADS-anxiety, and HADS-depression scores (r = 0.27, 0.33, and 0.29, respectively, p < 0.01). Multivariable analysis showed that CAT and HADS-anxiety scores had an independent and significant impact on the ASK-20 scores [β, standardized regression coefficient: 0.18 (95% CI, 0.03–0.35; p = 0.02), and 0.29 (95% CI, 0.17–0.42; p < 0.01), respectively]; however, the ASK-20 scores were not correlated with age, sex, body mass index, cohabitation, modified Medical Research Council Dyspnea Scale score, pulmonary function, disease duration, number of COPD exacerbations per year, comorbidities, inhaler numbers, nor inhaler components. Conclusion The ASK-20 scores in patients with COPD were significantly associated with CAT and HADS scores. In Japan, Respimat was prescribed to younger patients and patients with lower CAT scores. The ASK-20, a simple evaluation method, is useful for identifying clinical factors affecting adherence in patients with COPD.
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Affiliation(s)
- Kaho Akimoto
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kuniaki Hirai
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tomohiro Matsunaga
- Division of Allergology and Respiratory Medicine, Department of Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Keisuke Kaneko
- Department of Pulmonary Medicine, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan
| | - Hatsuko Mikuni
- Department of Respiratory Medicine, Asahi General Hospital, Chiba, Japan
| | - Tomoko Kawahara
- Department of Respiratory Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan
| | - Tomoki Uno
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akiko Fujiwara
- Department of Respiratory, Odawara Municipal Hospital, Kanagawa, Japan
| | - Yoshito Miyata
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Homma
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hideki Inoue
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Fumihiro Yamaguchi
- Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Sojiro Kusumoto
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shintaro Suzuki
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Tanaka
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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17
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Saito M, Iwai Y, Kurokawa M, Harada R, Nemoto MW, Uno T. The Relationship Between Pelvic Fractures Within the Irradiation Field Among Elderly Asian Women Who Have Received Definitive Radiation Therapy for Cervical Cancer Treatment. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Inoue H, Jinno M, Ohta S, Kishino Y, Kawahara T, Mikuni H, Sato H, Yamamoto M, Sato Y, Onitsuka C, Goto Y, Ikeda H, Sato H, Uno T, Uchida Y, Kimura T, Miyata Y, Hirai K, Homma T, Watanabe Y, Kusumoto S, Suzuki S, Tokimatsu I, Tanaka A, Sagara H. Combination treatment of short-course systemic corticosteroid and favipiravir in a successfully treated case of critically ill COVID-19 pneumonia with COPD. Respir Med Case Rep 2020; 31:101200. [PMID: 32868989 PMCID: PMC7450252 DOI: 10.1016/j.rmcr.2020.101200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/23/2020] [Indexed: 12/31/2022] Open
Abstract
Use of systemic corticosteroids for the treatment for coronavirus disease 2019 (COVID-19) among chronic obstructive pulmonary disease (COPD) patients is not well described. A 58-year-old man with fever and progressive dyspnea was admitted to the Showa University Hospital, and showed severe respiratory failure which needed mechanical ventilation. His chest computed tomography scanning showed emphysema and bilateral ground-glass opacity caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. He received 30 mg prednisolone for five days with antiviral drug of favipiravir, and was successfully extubated on day five. A SARS-CoV-2 polymerase chain reaction (PCR) test became negative on day 15. He was discharged on day 21. Serum IgM and IgG antibodies against SARS-CoV-2 converted to positive on day 7 and they kept positive on day 54 for both IgM and IgG. Combination treatment of short-course systemic corticosteroid and favipiravir might improve the prognosis for critically ill COVID-19 pneumonia with COPD without negative influence on viral clearance or antibody production.
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Key Words
- ARDS, acute respiratory distress syndrome
- COPD
- COPD, chronic obstructive pulmonary disease
- COVID-19
- COVID-19, coronavirus disease 2019
- CRP, C-reactive protein
- CT, computed tomography
- Favipiravir
- GOLD, The Global Initiative for Chronic Obstructive Lung Disease
- ICU, intensive care unit
- MERS, middle east respiratory syndrome
- PCR, polymerase chain reaction
- Pneumonia
- RSV, respiratory syncytial virus
- SARS-CoV-2
- SFTSV, severe fever with thrombocytopenia syndrome virus
- SRAS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SpO2, peripheral capillary oxygen saturation
- Systemic corticosteroid
- WBC, white blood cell
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Affiliation(s)
- Hideki Inoue
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Megumi Jinno
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Shin Ohta
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Yasunari Kishino
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Tomoko Kawahara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Hatsuko Mikuni
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Haruna Sato
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Mayumi Yamamoto
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Yoko Sato
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Chisato Onitsuka
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Yuiko Goto
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Hitoshi Ikeda
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Hiroki Sato
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Tomoki Uno
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Yoshitaka Uchida
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Tomoyuki Kimura
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Yoshito Miyata
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Kuniaki Hirai
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Tetsuya Homma
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Yoshio Watanabe
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Sojiro Kusumoto
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Shintaro Suzuki
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Issei Tokimatsu
- Division of Infectious Diseases, Department of Medicine, Showa University School of Medicine, Japan
| | - Akihiko Tanaka
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Hironori Sagara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
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Miyata Y, Ohta S, Tanaka A, Kashima A, Suganuma H, Uno T, Sato H, Ida H, Kimura T, Jinno M, Hirai K, Homma T, Yamamoto M, Watanabe Y, Suzuki S, Sagara H. The Effect of Bronchoconstriction by Methacholine Inhalation in a Murine Model of Asthma. Int Arch Allergy Immunol 2020; 181:897-907. [PMID: 32791506 DOI: 10.1159/000509606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 06/23/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Bronchoconstriction was recently shown to cause airway remodeling and induce allergic airway inflammation in asthma. However, the mechanisms how mechanical stress via bronchoconstriction could induce airway inflammation and remodeling remain unclear. OBJECTIVE We investigated the effect of bronchoconstriction induced by methacholine inhalation in a murine model of asthma. METHODS BALB/c female mice were sensitized and challenged with ovalbumin (OVA), followed by treatment with methacholine by a nebulizer twice a day for 7 days. Twenty-four hours after the last methacholine treatment, the bronchoalveolar lavage fluid (BALF) and lung tissues were collected. The BALF was analyzed for total and differential cell counts and cytokine levels. The lung tissues were analyzed for goblet cell metaplasia, thickness of the smooth muscle, and lung fibrosis. The expression of cytokines in the lung was also examined. RESULTS OVA sensitization and challenge induced infiltration of total cells, macrophages, and eosinophils in the BALF along with goblet cell metaplasia and increased airway smooth muscle hypertrophy. Seven days after the last OVA challenge, untreated mice achieved reduction in airway inflammation, while methacholine maintained the number of BALF total cells, macrophages, and eosinophils. The percentage of goblet cells and the thickness of airway smooth muscle were also maintained by methacholine. Moreover, the treatment of methacholine induced the expression of transforming growth factor (TGF)-β in the lung. This result indicates that the production of TGF-β is involved in induction of airway remodeling caused by bronchoconstriction with methacholine. CONCLUSIONS Repeated bronchoconstriction caused by methacholine inhalation elicited allergic airway inflammation and airway remodeling.
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Affiliation(s)
- Yoshito Miyata
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan,
| | - Akihiko Tanaka
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Ayaka Kashima
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Hiromitsu Suganuma
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Haruna Sato
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Hitomi Ida
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoyuki Kimura
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Megumi Jinno
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Kuniaki Hirai
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Homma
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Mayumi Yamamoto
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Yoshio Watanabe
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shintaro Suzuki
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Department of Internal Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
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Tsuchiya S, Saiga A, Yokota H, Kubota Y, Wada T, Akutsu A, Horikoshi T, Uno T. Abstract No. 402 Prophylactic steroids for preventing post embolization syndrome after transcatheter arterial embolization for renal angiomyolipoma. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Homma T, Fukuda Y, Uchida Y, Uno T, Jinno M, Kishino Y, Yamamoto M, Sato H, Akimoto K, Kaneko K, Fujiwara A, Sato H, Hirai K, Miyata Y, Inoue H, Ohta S, Watanabe Y, Kusumoto S, Ando K, Suzuki S, Yamaoka T, Tanaka A, Ohmori T, Sagara H. Inhibition of Virus-Induced Cytokine Production from Airway Epithelial Cells by the Late Addition of Budesonide. ACTA ACUST UNITED AC 2020; 56:medicina56030098. [PMID: 32120846 PMCID: PMC7143102 DOI: 10.3390/medicina56030098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/16/2020] [Accepted: 02/21/2020] [Indexed: 12/25/2022]
Abstract
Background and objectives: Viral infection is the main cause of asthma and COPD (chronic obstructive pulmonary disease) exacerbation and accumulate inflammatory cells to airway tissue. We have reported poly I:C, a mimic product of the virus and ligand of toll-like receptor 3 (TLR3), induced inflammatory chemokines from airway epithelial cells and found prior incubation with corticosteroids diminishes the effect of TLR3 activation. In clinical practice, mild asthma is recommended as-needed budesonide (BUD) when symptoms occur following a viral infection, etc. However, many questions still surround BUD’s usefulness if taken after a virus has already infected airway tissue. The aim of this study was to investigate the inhibitory effects of BUD on inflammatory cytokines induced by viral infection. Materials and Methods: Normal human bronchial epithelial (NHBE) cells were stimulated with poly I:C or infected with human rhinovirus-16 (HRV16) and BUD was added after the initial stimulation. Expression of both thymic stromal lymphopoietin (TSLP) and CCL26/eotaxin-3 was quantified by real-time RT-PCR and enzyme-linked immunosorbent assay (ELISA), respectively. Knockdown study was performed. Results: Pre-or post-incubation with BUD inhibited both poly I:C- and HRV16-induced mRNAs and proteins of both thymic stromal lymphopoietin (TSLP) and CCL26 with significance. Knockdown of the glucocorticoid receptor diminished these effects of BUD. Under the same conditions of BUD’s experiment, post-incubation with neither fluticasone propionate nor dexamethasone suppressed expression of both TSLP and CCL26, which induced by poly I:C. Conclusion: Post-addition of BUD inhibited the virus-induced TSLP and CCL26 from the airway epithelial cells. These results suggest that inhalation of BUD after viral infection has beneficial effects on asthma. Conclusion: Late addition of BUD may benefit among patient with viral infection and type 2 allergic airway disease such as asthma.
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Affiliation(s)
- Tetsuya Homma
- Correspondence: ; Tel.: +81-3-3784-8532; Fax: +81-3-3784-8742
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Kimura T, Suzuki S, Suganuma H, Sato H, Akimoto K, Kashima A, Matsunaga T, Ebato T, Yamamoto S, Uno T, Sato H, Uchida Y, Fukuda Y, Ida H, Jinno M, Hirai K, Miyata Y, Honma T, Ota S, Kusumoto S, Watanabe Y, Yamamoto M, Tanaka A, Sagara H. [A CASE OF ANAPHYLAXIS DUE TO STINGING OF A Brachyponera chinensis]. Arerugi 2020; 69:683-688. [PMID: 32963192 DOI: 10.15036/arerugi.69.683] [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: 06/11/2023]
Abstract
The case involved a man in his forties. While working at the restaurant that the patient runs, the patient experienced a stab-like pain on the left shoulder and developed systemic pruritic eruptions. He was diagnosed with anaphylaxis upon visiting our emergency department. Conjunctival hyperemia, lip swelling, cold sweats, and nausea presented later. A cap fluorescence enzyme immunoassay using the serum of the patient showed specific immunoglobulin E (IgE) positivity for wasps; therefore, we hypothesized that he had anaphylaxis caused by the insect's sting. Insects of the same species as that by which the patient had been stung were collected and finally identified as the Asian needle ant (Brachyponera chinensis). The freeze-dried insects' bodies were sonicated into powders and stored for following examinations. Next, a basophil activation test was performed using the patient's whole blood treated with the reagent above, which showed positivity. Furthermore, a skin prick test using the same reagent showed a positive result, and the reaction increased in a concentrationdependent manner. Based on these results, the patient was diagnosed with anaphylaxis after a sting by the ant. Based on the results of the allergen component specific IgE test, we speculated that the pathogens in this case was group5 allergen of the Asian needle ant. Anaphylaxis following insect stings by this ant has been reported frequently in South Korea. However, it is quite rare in Japan, although the ant is native to Japan. Clinicians should consider that this allergy can occur indoors, unlike allergies to other types of venom.
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Affiliation(s)
- Tomoyuki Kimura
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Shintaro Suzuki
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Hiromitsu Suganuma
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Hiroki Sato
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Kaho Akimoto
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Ayaka Kashima
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Tomohiro Matsunaga
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Takaya Ebato
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Shigenori Yamamoto
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Tomoki Uno
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Haruna Sato
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Yoshitaka Uchida
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Yosuke Fukuda
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Hitomi Ida
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Megumi Jinno
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Kuniaki Hirai
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Yoshito Miyata
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Tetsuya Honma
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Shin Ota
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Sojiro Kusumoto
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Yoshio Watanabe
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Mayumi Yamamoto
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Akihiko Tanaka
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
| | - Hironori Sagara
- Department of Medicine, Division of Allergology and Respiratory medicine, School of Medicine, Showa University
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Kodaira T, Kagami Y, Shibata T, Shikama N, Nishimura Y, Ishikura S, Nakamura K, Saito Y, Matsumoto Y, Teshima T, Ito Y, Akimoto T, Nakata K, Toshiyasu T, Nakagawa K, Nagata Y, Nishimura T, Uno T, Kataoka M, Yorozu A, Hiraoka M. Results of a multi-institutional, randomized, non-inferiority, phase III trial of accelerated fractionation versus standard fractionation in radiation therapy for T1-2N0M0 glottic cancer: Japan Clinical Oncology Group Study (JCOG0701). Ann Oncol 2019; 29:992-997. [PMID: 29401241 DOI: 10.1093/annonc/mdy036] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background We assessed the non-inferiority of accelerated fractionation (AF) (2.4 Gy/fraction) compared with standard fractionation (SF) (2 Gy/fraction) regarding progression-free survival (PFS) in patients with T1-2N0M0 glottic cancer (GC). Patients and methods In this multi-institutional, randomized, phase III trial, patients were enrolled from 32 Japanese institutions. Key inclusion criteria were GC T1-2N0M0, age 20-80, Eastern Cooperative Oncology Group performance status of 0-1, and adequate organ function. Patients were randomly assigned to receive either SF of 66-70 Gy (33-35 fractions), or AF of 60-64.8 Gy (25-27 fractions). The primary end point was the proportion of 3-year PFS. The planned sample size was 360 with a non-inferiority margin of 5%. Results Between 2007 and 2013, 370 patients were randomized (184/186 to SF/AF). Three-year PFS was 79.9% (95% confidence interval [CI] 73.4-85.4) for SF and 81.7% (95% CI 75.4-87.0) for AF (difference 1.8%, 91% CI-5.1% to 8.8%; one-sided P = 0.047 > 0.045). The cumulative incidences of local failure at 3 years for SF/AF were 15.9%/10.3%. No significant difference was observed in 3-year overall survival (OS) between SF and AF. Grade 3 or 4 acute and late toxicities developed in 22 (12.4%)/21 (11.5%) and 2 (1.1%)/1 (0.5%) in the SF/AF arms. Conclusion Although the non-inferiority of AF was not confirmed statistically, the similar efficacy and toxicity of AF compared with SF, as well as the practical convenience of its fewer treatment sessions, suggest the potential of AF as a treatment option for early GC. Clinical trials registration UMIN Clinical Trial Registry, number UMIN000000819.
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Affiliation(s)
- T Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
| | - Y Kagami
- Department of Radiation Oncology, Showa University, Tokyo, Japan
| | - T Shibata
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - N Shikama
- Department of Radiation Oncology, Juntendo University, Tokyo, Japan
| | - Y Nishimura
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Ishikura
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - K Nakamura
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Y Saito
- Department of Radiation Oncology, Saitama Cancer Center, Saitama, Japan
| | - Y Matsumoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - T Teshima
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Y Ito
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - T Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - K Nakata
- Department of Radiology, Sapporo Medical University, Sapporo, Japan
| | - T Toshiyasu
- Department of Radiation Oncology, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - K Nakagawa
- Department of Radiology, Tokyo University, Tokyo, Japan
| | - Y Nagata
- Department of Radiation Oncology, Hiroshima University, Hiroshima, Japan
| | - T Nishimura
- Department of Radiation Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - T Uno
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - M Kataoka
- Department of Radiation Oncology, Shikoku Cancer Center, Matsuyama, Japan
| | - A Yorozu
- Department of Radiology, Tokyo Medical Center, Tokyo, Japan
| | - M Hiraoka
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Hospital, Kyoto, Japan
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Futami K, Uno T, Misaki K, Tamai S, Nambu I, Uchiyama N, Nakada M. Identification of Vortex Cores in Cerebral Aneurysms on 4D Flow MRI. AJNR Am J Neuroradiol 2019; 40:2111-2116. [PMID: 31753836 DOI: 10.3174/ajnr.a6322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/13/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The complexity and instability of the vortex flow in aneurysms are factors related to the rupture risk of unruptured cerebral aneurysms. We identified aneurysm vortex cores on 4D flow MR imaging and examined the relationship of these factors with the characteristics of cerebral aneurysms. MATERIALS AND METHODS We subjected 40 aneurysms (37 unruptured, 3 ruptured) to 4D flow MR imaging. We visualized streamlines with velocities below the threshold-that is, a percentage value of the aneurysm maximum inflow velocity-and progressively decreased the threshold to identify vortex cores as thin, streamline bundles with minimum velocities. Complexity and stability were compared in aneurysms with a smooth surface and those with blebs or daughter sacs. RESULTS The threshold for visualizing vortex cores ranged from 3% to 13% of the maximum inflow velocity. Vortex cores could be visualized in 38 aneurysms; in 2, they were not visualized through the cardiac cycle. A simple flow pattern (single vortex core) was identified in 27 aneurysms; the other 13 exhibited a complex flow pattern. The cores were stable in 32 and unstable in 8 aneurysms. Significantly more aneurysms with-than-without blebs or daughter sacs had a complex flow pattern (P = .006). Of the 3 ruptured aneurysms, 1 aneurysm had an unstable vortex core; in the other 2, the vortex core was not visualized. CONCLUSIONS The identification of vortex cores on 4D flow MR imaging may help to stratify the rupture risk of unruptured cerebral aneurysms.
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Affiliation(s)
- K Futami
- From the Department of Neurosurgery (K.F.), Hokuriku Central Hospital, Toyama, Japan
| | - T Uno
- Department of Neurosurgery (T.U., K.M., S.T., I.N., N.U., M.N.), Kanazawa University School of Medicine, Ishikawa, Japan
| | - K Misaki
- Department of Neurosurgery (T.U., K.M., S.T., I.N., N.U., M.N.), Kanazawa University School of Medicine, Ishikawa, Japan
| | - S Tamai
- Department of Neurosurgery (T.U., K.M., S.T., I.N., N.U., M.N.), Kanazawa University School of Medicine, Ishikawa, Japan
| | - I Nambu
- Department of Neurosurgery (T.U., K.M., S.T., I.N., N.U., M.N.), Kanazawa University School of Medicine, Ishikawa, Japan
| | - N Uchiyama
- Department of Neurosurgery (T.U., K.M., S.T., I.N., N.U., M.N.), Kanazawa University School of Medicine, Ishikawa, Japan
| | - M Nakada
- Department of Neurosurgery (T.U., K.M., S.T., I.N., N.U., M.N.), Kanazawa University School of Medicine, Ishikawa, Japan
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Nemoto MW, Iwai Y, Kanazawa A, Kurokawa M, Saito M, Harada R, Kobayashi H, Uno T. Single-Institution Experience in 3D MRI/CT-Based Brachytherapy for Cervical Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Onishi H, Shioyama Y, Matsuo Y, Takayama K, Miyakawa A, Yamashita H, Nomiya T, Matsumo Y, Matsushita H, Kimura T, Murakami N, Ishiyama H, Uno T, Takanaka T, Katoh N, Takeda A, Nakata K, Ogawa K, Nihei K, Aoki M, Kuriyama K, Komiyama T, Marino K, Araya M, Aoki S, Saito R, Maehata Y, Tominaga R, Nonaka H, Oguri M, Matsuda M, Yamada T, Akita T, Hiraoka M. Prognosis after Local Recurrence or Metastases in Medically Operable Stage I Non-Small Cell Lung Cancer Patients Treated By Stereotactic Body Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Hirai K, Tanaka A, Homma T, Kaneko K, Uno T, Sato H, Manabe R, Ohta S, Kusumoto S, Yamaguchi F, Suzuki S, Sagara H. Comparison of three frailty models and a sarcopenia model in elderly patients with chronic obstructive pulmonary disease. Geriatr Gerontol Int 2019; 19:896-901. [PMID: 31309700 DOI: 10.1111/ggi.13740] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 03/28/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 12/11/2022]
Abstract
AIM Frailty and sarcopenia affect the prognosis and quality of life of patients with chronic obstructive pulmonary disease (COPD). However, it remains uncertain which model is the most suitable for evaluating vulnerability in patients with COPD. We evaluated the validity of three frailty models - the Kihon Checklist (KCL), the Japanese version of the Cardiovascular Health Study and the Study of Osteoporotic Fractures - and one sarcopenia model for older patients with COPD. METHODS This cross-sectional study included 201 older (aged ≥65 years) outpatients with COPD. We used three frailty models and one sarcopenia model to identify their correlation with various indices that can evaluate the status of COPD and determine the most ideal model for evaluating vulnerability in patients with COPD. RESULTS The highest prevalence of frailty (38%) and lowest prevalence of robustness (26%) were observed using the KCL. Although all models reflected the characteristics of COPD, the KCL yielded the strongest correlations with clinically important physical, psychological and prognostic indices. The KCL yielded statistically significant differences in almost all indices among the three intergroup comparisons (robust, pre-frailty and frailty). The KCL was superior in extracting mood disorders to the other models. CONCLUSION Although all investigated models were useful, the KCL was the most suitable for evaluating the frailty status and might enable interventions in patients with COPD. Geriatr Gerontol Int 2019; 19: 896-901.
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Affiliation(s)
- Kuniaki Hirai
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Tanaka
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Homma
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Keisuke Kaneko
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Haruna Sato
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Ryo Manabe
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Sojiro Kusumoto
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Fumihiro Yamaguchi
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Shintaro Suzuki
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
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Takada A, Yokota H, Watanabe M, Horikoshi T, Uno T. OC-0509 MRI radiomics analysis for predicting prognosis of cervical cancer after definitive radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30929-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Uno T, Kobayashi H, Watanabe-Nemoto M, Harada R, Saito M, Kanazawa A, Iwai Y, Murakami K, Matsubara H. EP-1401 Practice-based clinical outcome of definitive radiation therapy for superficial esophageal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31821-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Homma T, Kawahara T, Mikuni H, Uno T, Sato H, Fujiwara A, Uchida Y, Fukuda Y, Manabe R, Ida H, Kuwahara N, Kimura T, Hirai K, Miyata Y, Jinno M, Yamaguchi M, Kishino Y, Murata Y, Ohta S, Yamamoto M, Watanabe Y, Yamaguchi H, Kusumoto S, Suzuki S, Tanaka A, Yokoe T, Ohnishi T, Sagara H. Beneficial Effect of Early Intervention with Garenoxacin for Bacterial Infection-Induced Acute Exacerbation of Bronchial Asthma and Chronic Obstructive Pulmonary Disease. Int Arch Allergy Immunol 2019; 178:355-362. [PMID: 30759444 DOI: 10.1159/000495761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 11/23/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) and asthma have similar clinical features and are both exacerbated by airway infection. OBJECTIVE To determine whether garenoxacin mesylate hydrate (GRNX) added to the standard care for bacterial infection-induced acute exacerbation of asthma or COPD in adults has clinical benefits. METHOD This single-arm clinical trial was conducted from January 2015 to March 2016. Adults with a history of asthma or COPD for more than 12 months were recruited within 48 h of presentation with fever and acute deterioration of asthma or COPD requiring additional intervention. Participants were administered 400 mg GRNX daily for 7 days without additional systemic corticosteroids or other antibiotics. The primary outcome was efficacy of GRNX based on clinical symptoms and blood test results after 7 days of treatment. Secondary outcomes were: (1) comparison of the blood test results, radiograph findings, and bacterial culture surveillance before and after treatment; (2) effectiveness of GRNX after 3 days of administration; (3) analyzation of patient symptoms based on patient diary; and (4) continued effectiveness of GRNX on 14th day after the treatment (visit 3). RESULTS The study included 44 febrile patients (34 asthma and 10 COPD). Frequently isolated bacteria included Moraxella catarrhalis (n = 6) and Klebsiella pneumoniae (n = 4). On visit 2, 40 patients responded, and no severe adverse events were observed. All secondary outcomes showed favorable results. CONCLUSION GRNX effectively treated asthma and COPD patients with acute bacterial infection without severe adverse events. Further research with a larger study population is needed.
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Affiliation(s)
- Tetsuya Homma
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan,
| | - Tomoko Kawahara
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hatsuko Mikuni
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Haruna Sato
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akiko Fujiwara
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yoshitaka Uchida
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yosuke Fukuda
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Ryo Manabe
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hitomi Ida
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Naota Kuwahara
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tomoyuki Kimura
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kuniaki Hirai
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yoshito Miyata
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Megumi Jinno
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Munehiro Yamaguchi
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yasunari Kishino
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yasunori Murata
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Mayumi Yamamoto
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yoshio Watanabe
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hirofumi Yamaguchi
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Sojiro Kusumoto
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shintaro Suzuki
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Tanaka
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takuya Yokoe
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tsukasa Ohnishi
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
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Ohta S, Jinno M, Tanaka A, Uno T, Uchida Y, Manabe R, Ida H, Kuwahara N, Fukuda Y, Kimura T, Hirai K, Miyata Y, Yamaguchi M, Homma T, Yamaguchi F, Watanabe Y, Suzuki S, Ohnishi T, Sagara H, Kusumoto S. The effect of muscarinic M3 receptor blockage in development of M2 macrophages in allergic inflammation. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kawaguchi Y, Nozaki M, Kagami Y, Shibata T, Nakamura K, Ito Y, Nishimura Y, Saito Y, Nagata Y, Matsumo Y, Akimoto T, Nishimura T, Uno T, Tsujino K, Kataoka M, Kodaira T, Shiraishi K, Inoue K, Isohashi F, Hiraoka M. A Multicenter Single-Arm Confirmatory Trial on Hypofractionated Whole-breast Irradiation after Breast-Conserving Surgery. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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33
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Hashiba J, Harada R, Watanabe Nemoto M, Togasaki G, Kurokawa M, Kobayashi H, Horikoshi T, Hanazawa T, Okamoto Y, Uno T. A Retrospective Study of 3D-CRT/IMRT and Concomitant Intra-arterial Chemotherapy for Maxillary Sinus Carcinoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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34
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Yokota H, Mukai H, Hattori S, Yamada K, Anzai Y, Uno T. MR Imaging of the Superior Cervical Ganglion and Inferior Ganglion of the Vagus Nerve: Structures That Can Mimic Pathologic Retropharyngeal Lymph Nodes. AJNR Am J Neuroradiol 2017; 39:170-176. [PMID: 29122764 DOI: 10.3174/ajnr.a5434] [Citation(s) in RCA: 11] [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: 04/27/2017] [Accepted: 08/28/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND PURPOSE The superior cervical ganglion and inferior ganglion of the vagus nerve can mimic pathologic retropharyngeal lymph nodes. We studied the cross-sectional anatomy of the superior cervical ganglion and inferior ganglion of the vagus nerve to evaluate how they can be differentiated from the retropharyngeal lymph nodes. MATERIALS AND METHODS This retrospective study consists of 2 parts. Cohort 1 concerned the signal intensity of routine neck MR imaging with 2D sequences, apparent diffusion coefficient, and contrast enhancement of the superior cervical ganglion compared with lymph nodes with or without metastasis in 30 patients. Cohort 2 used 3D neurography to assess the morphology and spatial relationships of the superior cervical ganglion, inferior ganglion of the vagus nerve, and the retropharyngeal lymph nodes in 50 other patients. RESULTS All superior cervical ganglions had homogeneously greater enhancement and lower signal on diffusion-weighted imaging than lymph nodes. Apparent diffusion coefficient values of the superior cervical ganglion (1.80 ± 0.28 × 10-3mm2/s) were significantly higher than normal and metastatic lymph nodes (0.86 ± 0.10 × 10-3mm2/s, P < .001, and 0.73 ± 0.10 × 10-3mm2/s, P < .001). Ten and 13 of 60 superior cervical ganglions were hypointense on T2-weighted images and had hyperintense spots on both T1- and T2-weighted images, respectively. The latter was considered fat tissue. The largest was the superior cervical ganglion, followed in order by the retropharyngeal lymph node and the inferior ganglion of the vagus nerve (P < .001 to P = .004). The highest at vertebral level was the retropharyngeal lymph nodes, followed, in order, by the inferior ganglion of the vagus nerve and the superior cervical ganglion (P < .001 to P = .001). The retropharyngeal lymph node, superior cervical ganglion, and inferior ganglion of the vagus nerve formed a line from anteromedial to posterolateral. CONCLUSIONS The superior cervical ganglion and the inferior ganglion of the vagus nerve can be almost always differentiated from retropharyngeal lymph nodes on MR imaging by evaluating the signal, size, and position.
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Affiliation(s)
- H Yokota
- From Diagnostic Radiology and Radiation Oncology (H.Y., H.M., S.H., T.U.), Graduate School of Medicine, Chiba University, Chiba, Japan
| | - H Mukai
- From Diagnostic Radiology and Radiation Oncology (H.Y., H.M., S.H., T.U.), Graduate School of Medicine, Chiba University, Chiba, Japan
| | - S Hattori
- From Diagnostic Radiology and Radiation Oncology (H.Y., H.M., S.H., T.U.), Graduate School of Medicine, Chiba University, Chiba, Japan
| | - K Yamada
- Department of Radiology (K.Y.), Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Y Anzai
- Department of Radiology (Y.A.), University of Utah School of Medicine Health Sciences, Salt Lake City, Utah
| | - T Uno
- From Diagnostic Radiology and Radiation Oncology (H.Y., H.M., S.H., T.U.), Graduate School of Medicine, Chiba University, Chiba, Japan
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Sakurai T, Hirano S, Nakano Y, Ishikawa A, Kojima K, Li H, Hong T, Mukai H, Uno T, Kuwabara S. Corticobasal syndrome subjects and scans without evidences of dopaminergic deficit; A retrospective neuroimaging study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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36
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Tanaka A, Uno T, Sato H, Jinno M, Hirai K, Miyata Y, Yamaguchi M, Ohta S, Homma T, Yamamoto M, Suzuki S, Yokoe T, Sagara H. Predicting future risk of exacerbations in Japanese patients with adult asthma: A prospective 1-year follow up study. Allergol Int 2017; 66:568-573. [PMID: 28318883 DOI: 10.1016/j.alit.2017.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/22/2017] [Accepted: 02/11/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND To avoid future risk is a definitive goal of long-term asthma management. Exacerbations are considered to be the most relevant future risk in real life asthma management. Few comparative studies have evaluated the risk factors associated with exacerbations in Japanese patients with asthma. METHODS We performed the prospective 1-year follow up study in Japanese patients with adult asthma. A total of 189 patients with asthma were enrolled and followed up for 1 year. Finally, 181 patients completed the study protocol. RESULTS Of 181 patients, 43 patients (23.8%) had exacerbations during the follow-up period. Among the 45 patients who had exacerbations during the preceding year, 32 patients (71.1%) had exacerbations. Prevalence of patients with previous exacerbations and those with previous admissions were significantly higher in patients with exacerbations than those with no exacerbation. Logistic regression analysis also identified a significant association between exacerbations during the follow-up period and exacerbations during the preceding year, admissions during the preceding 3 years, ACT score below 20, low %FVC (<80%), or low FEV1 (<70%), respectively. Of the 55 patients with severe asthma, 29 patients (52.7%) had exacerbations. Among the 36 patients with severe asthma with previous exacerbations, 26 patients (72.2%) had exacerbations. The history of exacerbations during the preceding year was associated with a significantly increased risk of exacerbations both among the patients with severe asthma and those with non-severe asthma. CONCLUSIONS This study implicated that exacerbations during the preceding year reliably predict future risk of exacerbations in Japanese patients with asthma.
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Yamamoto K, Ozakiya Y, Uno T. Localization of an Aldo-Keto Reductase (AKR2E4) in the Silkworm Bombyx mori (Lepidoptera: Bombycidae). J Insect Sci 2017; 17:4107059. [PMID: 28922901 PMCID: PMC5597883 DOI: 10.1093/jisesa/iex071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Indexed: 06/07/2023]
Abstract
The aldo-keto reductase AKR2E4 reduces 3-dehydroecdysone to ecdysone in the silkworm Bombyx mori L. In this study, a quantitative polymerase chain reaction analysis revealed that the level of AKR2E4 mRNA was higher in the testes than in other tissues, and a western immunoblot analysis revealed that the AKR2E4 content in the testes was stage-specific from the fifth larval instar to the pupal stage. Immunohistochemical analysis showed that the AKR2E4 protein was present in cyst cells associated with sperm cells and spermatocytes. These results indicate that AKR2E4 plays an important role in 3-dehydroecdysone conversion to ecdysone and spermatogenesis in silkworm testes.
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Affiliation(s)
- K Yamamoto
- Department of Bioscience and Biotechnology, Kyushu University Graduate School, 6-10-1 Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan
| | - Y Ozakiya
- Laboratory of Biological Chemistry, Department of Biofunctional Chemistry, Faculty of Agriculture, Kobe University, Nada-ku, Kobe, Hyogo 657-8501, Japan
| | - T Uno
- Laboratory of Biological Chemistry, Department of Biofunctional Chemistry, Faculty of Agriculture, Kobe University, Nada-ku, Kobe, Hyogo 657-8501, Japan
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38
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Uno T, Okumura Y, Kasai T. Print-specific N170 involves multiple subcomponents for Japanese Hiragana. Neurosci Lett 2017; 650:77-81. [PMID: 28412533 DOI: 10.1016/j.neulet.2017.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 04/01/2016] [Revised: 03/10/2017] [Accepted: 04/11/2017] [Indexed: 11/25/2022]
Abstract
Print-specific N170 in event-related potentials is generally considered to reflect relatively automatic processing for letter strings, which is crucial for fluent reading. However, our previous studies demonstrated that print-specific N170 for transparent Japanese Hiragana script consists of at least two subcomponents under rapid stimulus presentation: an attention-related left-lateralized N170 and a bilateral N170 associated with more automatic orthographic processes (Okumura, Kasai & Murohashi, 2014, 2015). The present study aimed to confirm the latter component by controlling presentation frequency of letters and nonlinguistic visual controls (i.e., symbols), but found a quite different pattern of results; an enhanced occipito-temporal positivity for words (80-120ms poststimulus) followed by the typical left-lateralized N170 and an enhanced parietal negativity for nonwords (150-200ms). These results should provide further insights into the interaction processes between attention and early stages of print processing.
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Affiliation(s)
- Tomoki Uno
- Graduate School of Education, Hokkaido University, Nishi-7, Kita-11, Kita-ku, Sapporo, Hokkaido, Japan.
| | - Yasuko Okumura
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi-cho, Kodaira, Tokyo, Japan.
| | - Tetsuko Kasai
- Faculty of Education, Hokkaido University, Nishi-7, Kita-11, Kita-ku, Sapporo, Hokkaido, Japan.
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Nozaki M, Kagami Y, Shibata T, Nakamura K, Ito Y, Nishimura Y, Kawaguchi Y, Saito Y, Nagata Y, Matsumoto Y, Akimoto T, Nishimura T, Uno T, Tsujino K, Kataoka M, Kodaira T, Shiraishi K, Inoue K, Isohashi F, Hiraoka M, Karasawa K, Izumi S, Sakurai H. EP-1156: A clinical trial on hypofractionated whole breast irradiation after breast-conserving surgery. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31592-x] [Citation(s) in RCA: 1] [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: 10/19/2022]
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40
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Onishi H, Shioyama Y, Matsumoto Y, Takayama K, Matsuo Y, Miyakawa A, Yamashita H, Matsushita H, Aoki M, Nihei K, Kimura T, Ishiyama H, Murakami N, Nakata K, Takeda A, Uno T, Nomiya T, Takanaka T, Seo Y. Excellent Survival! Multi-Institutional Study of Stereotactic Body Radiation Therapy for Medically Operable and Young (70 Years Old or Younger) Patients With Stage I Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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41
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Nemoto MW, Ikeda Y, Ii N, Toita T, Togasaki G, Kanazawa A, Kurokawa M, Harada R, Kobayashi H, Matsumoto K, Masuda Y, Uno T. Multi-Institutional Comparative Study of MRI Technique in Cervical Cancer Image-Based Brachytherapy (IGBT): 3D MRI With High Sampling Efficiency Versus Conventional 2D Multiplanar MRI. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Verstovsek S, Talpaz M, Ritchie E, Wadleigh M, Odenike O, Jamieson C, Stein B, Uno T, Mesa RA. A phase I, open-label, dose-escalation, multicenter study of the JAK2 inhibitor NS-018 in patients with myelofibrosis. Leukemia 2016; 31:393-402. [PMID: 27479177 PMCID: PMC5292677 DOI: 10.1038/leu.2016.215] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/24/2016] [Accepted: 07/04/2016] [Indexed: 12/13/2022]
Abstract
NS-018 is a Janus-activated kinase 2 (JAK2)-selective inhibitor, targeting the JAK–signal transducer and activator of transcription (STAT) pathway that is deregulated in myelofibrosis. In this phase I, dose-escalation portion of a phase I/II study, patients with myelofibrosis received oral NS-018 in continuous 28-day cycles. The primary study objective was to evaluate safety, tolerability and clinically active dose of NS-018. Forty-eight patients were treated; 23 (48%) had previously received a JAK inhibitor (JAKi). The most common drug-related adverse events were thrombocytopenia (27%)/anemia (15%) for hematologic events, and dizziness (23%)/nausea (19%) for non-hematologic events. Once daily NS-018 at 300 mg was chosen as the phase II study dose based on improved tolerability compared with higher doses. A ⩾50% reduction in palpable spleen size was achieved in 56% of patients (47% of patients with prior JAKi treatment), and improvements were observed in myelofibrosis-associated symptoms. Bone marrow fibrosis grade (local assessment) improved from baseline in 11/30 evaluable patients (37%) after 3 cycles of NS-018. JAK2 allele burden was largely unchanged. Changes in cytokine/protein levels were noted after 4 weeks of treatment. NS-018 reached peak plasma concentration in 1–2 h and did not accumulate with multiple dosing. NS-018 will be assessed in patients with previous JAKi exposure in the phase II portion.
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Affiliation(s)
- S Verstovsek
- Department of Leukemia, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - M Talpaz
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - E Ritchie
- Division of Hematology and Medical Oncology, Cornell University, New York, NY, USA
| | - M Wadleigh
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - O Odenike
- University of Chicago Medical Center, Chicago, IL, USA
| | - C Jamieson
- Moores Cancer Center, University of California, San Diego, CA, USA
| | - B Stein
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - T Uno
- NS Pharma Inc., Paramus, NJ, USA
| | - R A Mesa
- Mayo Clinic, Scottsdale, AZ, USA
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Akamine Y, Uehara H, Miura M, Yasui-Furukori N, Uno T. Multiple inductive effects of carbamazepine on combined therapy with paliperidone and amlodipine. J Clin Pharm Ther 2015; 40:480-2. [DOI: 10.1111/jcpt.12286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 04/27/2015] [Indexed: 01/16/2023]
Affiliation(s)
- Y. Akamine
- Department of Pharmacy; Akita University Hospital; Akita Japan
| | - H. Uehara
- Department of Hospital Pharmacy; Faculty of Medicine; University of the Ryukyus; Okinawa Japan
| | - M. Miura
- Department of Pharmacy; Akita University Hospital; Akita Japan
| | - N. Yasui-Furukori
- Department of Neuropsychiatry; Hirosaki University School of Medicine; Hirosaki Japan
| | - T. Uno
- Department of Pharmacy; Zikeikai-Aoimori Hospital; Aomori Japan
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45
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Uno T, Okumura Y, Kasai T. An event-related potential study on matching processes of numeral classifiers and nouns. Int J Psychophysiol 2014. [DOI: 10.1016/j.ijpsycho.2014.08.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Akamine Y, Miura M, Yasui-Furukori N, Ieiri I, Uno T. Effects of multiple-dose rifampicin 450 mg on the pharmacokinetics of fexofenadine enantiomers in Japanese volunteers. J Clin Pharm Ther 2014; 40:98-103. [DOI: 10.1111/jcpt.12213] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/03/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Y. Akamine
- Department of Hospital Pharmacy; Faculty of Medicine; University of the Ryukyus; Okinawa Japan
- Department of Clinical Pharmacokinetics; Graduate School of Pharmaceutical Sciences; Kyushu University; Fukuoka Japan
| | - M. Miura
- Department of Pharmacy; Akita University Hospital; Akita Japan
| | - N. Yasui-Furukori
- Department of Neuropsychiatry; Hirosaki University School of Medicine; Hirosaki Japan
| | - I. Ieiri
- Department of Clinical Pharmacokinetics; Graduate School of Pharmaceutical Sciences; Kyushu University; Fukuoka Japan
| | - T. Uno
- Department of Hospital Pharmacy; Faculty of Medicine; University of the Ryukyus; Okinawa Japan
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Vaidyanathan G, Gururangan S, Bigner D, Zalutsky M, Morfouace M, Shelat A, Megan J, Freeman BB, Robinson S, Throm S, Olson JM, Li XN, Guy KR, Robinson G, Stewart C, Gajjar A, Roussel M, Sirachainan N, Pakakasama S, Anurathapan U, Hansasuta A, Dhanachai M, Khongkhatithum C, Hongeng S, Feroze A, Lee KS, Gholamin S, Wu Z, Lu B, Mitra S, Cheshier S, Northcott P, Lee C, Zichner T, Lichter P, Korbel J, Wechsler-Reya R, Pfister S, Project IPT, Li KKW, Xia T, Ma FMT, Zhang R, Zhou L, Lau KM, Ng HK, Lafay-Cousin L, Chi S, Madden J, Smith A, Wells E, Owens E, Strother D, Foreman N, Packer R, Bouffet E, Wataya T, Peacock J, Taylor MD, Ivanov D, Garnett M, Parker T, Alexander C, Meijer L, Grundy R, Gellert P, Ashford M, Walker D, Brent J, Cader FZ, Ford D, Kay A, Walsh R, Solanki G, Peet A, English M, Shalaby T, Fiaschetti G, Baulande S, Gerber N, Baumgartner M, Grotzer M, Hayase T, Kawahara Y, Yagi M, Minami T, Kanai N, Yamaguchi T, Gomi A, Morimoto A, Hill R, Kuijper S, Lindsey J, Schwalbe E, 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Saito M, Tougasaki G, Kanazawa A, Harada R, Watanabe Nemoto M, Isobe K, Uno T. Treatment Outcome of Combined Radiation Therapy and Intra-arterial (IA) Chemotherapy for Advanced Maxillary Sinus Carcinoma. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Uno T, Nemoto M, Harada R, Saitou M, Togasaki G, Kanazawa A, Mitsuhashi A, Isobe K. Failure Pattern in Patients With Intermediate- to High-Risk Cervical Cancer Treated With Postoperative Chemoradiation Using CT-Based Nodal-CTV Delineation. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Watanabe M, Isobe K, Kanazawa A, Togasaki G, Harada R, Kobayashi H, Uno T. Delayed Renal Dysfunction After Total Body Irradiation in Pediatric Malignancies. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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