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Okazaki E, Hattori S, Tomomatsu K, Iijima S, Umemoto K, Yamazaki K, Horio Y, Hayama N, Ito Y, Oguma T, Asano K. Chronic Pasteurella Multocida Bronchitis Diagnosed 3 Years After Onset of Symptoms. Tokai J Exp Clin Med 2024; 49:9-11. [PMID: 38509006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/06/2023] [Indexed: 03/22/2024]
Abstract
We report a case of chronic infection with Pasteurella multocida in the lower respiratory tract in a man with a cat. A 77-year-old man presented with recurrent hemoptysis accompanied by bronchiectasis and an opacity in the left lung on chest computed tomography. Although the patient was seropositive for Mycobacterium avium complex, repeated sputum cultures were negative for any specific pathogen. Three years later, he was referred to our hospital for hemoptysis with enhanced opacity in the lower lobe of the left lung. Culture of bronchial lavage fluid obtained via bronchoscopy was positive for P. multocida. The patient was treated with amoxicillin-clavulanic acid for 14 days and was instructed to avoid close contact with his cat. His symptoms and chest imaging findings improved and have not recurred during more than 1 1/2 years of follow up. P. multocida can cause chronic lower respiratory infections.
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Affiliation(s)
| | | | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Hattori S, Oguma T, Ishiguro T, Suzuki J, Fukunaga K, Shimoda T, Kimura H, Obase Y, Okada N, Tanaka J, Kitahara A, Tomomatsu K, Shiraishi Y, Asano K. High attenuation mucus in bronchi with allergic bronchopulmonary mycosis. Mycoses 2024; 67:e13705. [PMID: 38369597 DOI: 10.1111/myc.13705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND High-attenuation mucus (HAM) is a specific manifestation of allergic bronchopulmonary mycosis (ABPM) on chest computed tomography (CT). OBJECTIVES To compare the diagnostic accuracy of the two definitions of HAM and to clarify the clinical and radiographic characteristics of HAM-positive and HAM-negative ABPM. METHODS CT images at the diagnosis of ABPM using Asano's criteria were retrospectively analysed. In Study #1, radiographic data obtained using the same CT apparatus in a single institute were analysed to determine the agreement between the two definitions of HAM: a mucus plug that is visually denser than the paraspinal muscles or that with a radiodensity ≥70 Hounsfield units. In Study #2, HAM was diagnosed by comparison with the paraspinal muscles in patients with ABPM reporting to 14 medical institutes in Japan. RESULTS In Study #1, 93 mucus plugs from 26 patients were analysed. A substantial agreement for HAM diagnosis was observed between the two methods, with a κ coefficient of 0.72. In Study #2, 60 cases of ABPM were analysed; mucus plugs were present in all cases and HAM was diagnosed in 45 (75%) cases. The median A. fumigatus-specific IgE titre was significantly lower in HAM-positive patients than in HAM-negative patients (2.5 vs. 24.3 UA /mL, p = .004). Nodular shadows were observed more frequently in the airways distal to HAM than in those distal to non-HAM mucus plugs (59% vs. 32%, p < .001). CONCLUSION In conclusion, agreement between the two methods to diagnose HAM was substantial. HAM was associated with some immunological and radiographic characteristics, including lower levels of sensitization to A. fumigatus and the presence of distal airway lesions.
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Affiliation(s)
- Shigeaki Hattori
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
| | - Junko Suzuki
- Department of Allergy, Clinical Research Center, National Hospital Organization Fukuoka Hospital, Fukuoka, Japan
| | - Koichi Fukunaga
- Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Terufumi Shimoda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hirokazu Kimura
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Okada
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Asako Kitahara
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Yoshiki Shiraishi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Oguma T, Ishiguro T, Kamei K, Tanaka J, Suzuki J, Hebisawa A, Obase Y, Mukae H, Tanosaki T, Furusho S, Kurokawa K, Watai K, Matsuse H, Harada N, Nakamura A, Shibayama T, Baba R, Fukunaga K, Matsumoto H, Ohba H, Sakamoto S, Suzuki S, Tanaka S, Yamada T, Yamasaki A, Fukutomi Y, Shiraishi Y, Toyotome T, Fukunaga K, Shimoda T, Konno S, Taniguchi M, Tomomatsu K, Okada N, Asano K. Clinical characteristics of allergic bronchopulmonary mycosis caused by Schizophyllum commune. Clin Transl Allergy 2024; 14:e12327. [PMID: 38282191 PMCID: PMC10758016 DOI: 10.1002/clt2.12327] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Allergic bronchopulmonary mycosis (ABPM) is an allergic disease caused by type I and type III hypersensitivity to environmental fungi. Schizophyllum commune, a basidiomycete fungus, is one of the most common fungi that causes non-Aspergillus ABPM. OBJECTIVE Herein, we attempted to clarify the clinical characteristics of ABPM caused by S. commune (ABPM-Sc) compared with those of allergic bronchopulmonary aspergillosis (ABPA). METHODS Patients with ABPM-Sc or ABPA were recruited from a nationwide survey in Japan, a multicenter cohort, and a fungal database at the Medical Mycology Research Center of Chiba University. The definition of culture-positive ABPM-Sc/ABPA is as follows: (1) fulfills five or more of the 10 diagnostic criteria for ABPM proposed by Asano et al., and (2) positive culture of S. commune/Aspergillus spp. in sputum, bronchial lavage fluid, or mucus plugs in the bronchi. RESULTS Thirty patients with ABPM-Sc and 46 with ABPA were recruited. Patients with ABPM-Sc exhibited less severe asthma and presented with better pulmonary function than those with ABPA (p = 0.008-0.03). Central bronchiectasis was more common in ABPM-Sc than that in ABPA, whereas peripheral lung lesions, including infiltrates/ground-glass opacities or fibrotic/cystic changes, were less frequent in ABPM-Sc. Aspergillus fumigatus-specific immunoglobulin (Ig)E was negative in 10 patients (34%) with ABPM-Sc, who demonstrated a lower prevalence of asthma and levels of total serum IgE than those with ABPM-Sc positive for A. fumigatus-specific IgE or ABPA. CONCLUSIONS Clinical characteristics of ABPM-Sc, especially those negative for A. fumigatus-specific IgE, differed from those of ABPA.
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Okada N, Yamamoto Y, Oguma T, Tanaka J, Tomomatsu K, Shiraishi Y, Matsuse H, Shimoda T, Kimura H, Watai K, Harada T, Fujita Y, Obase Y, Suzukawa M, Suzuki J, Takayanagi N, Ishiguro T, Masaki K, Fukunaga K, Asano K. Allergic bronchopulmonary aspergillosis with atopic, nonatopic, and sans asthma-Factor analysis. Allergy 2023; 78:2933-2943. [PMID: 37458287 DOI: 10.1111/all.15820] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/11/2023] [Accepted: 06/01/2023] [Indexed: 11/11/2023]
Abstract
BACKGROUND Allergic bronchopulmonary aspergillosis (ABPA) develops in the presence or absence of asthma, either atopic or nonatopic. We have tried to explore the essential components in the pathogenesis of the disease, which are either consistent and variable according to the presence and type of asthma. METHODS Non-cystic fibrosis ABPA cases satisfying Asano's criteria were extracted from a prospective registry of ABPA and related diseases in Japan between 2013 and 2023. According to the type of preceding asthma, ABPA was classified into three groups: ABPA sans asthma (no preceding asthma), ABPA with atopic asthma, and ABPA with nonatopic asthma. Exploratory and confirmatory factor analyses were performed to identify the components that determined the clinical characteristics of ABPA. RESULTS Among 106 cases of ABPA, 25 patients (24%) had ABPA sans asthma, whereas 57 (54%) and 24 (23%) had ABPA with atopic and nonatopic asthma, respectively. Factor analysis identified three components: allergic, eosinophilic, and fungal. Patients with atopic asthma showed the highest scores for the allergic component (p < .001), defined by total and allergen-specific IgE titers and lung opacities, and the lowest scores for the fungal component defined by the presence of specific precipitin/IgG or positive culture for A. fumigatus. Eosinophilic components, including peripheral blood eosinophil counts and presence of mucus plugs/high attenuation mucus in the bronchi, were consistent among the three groups. CONCLUSION The eosinophilic component of ABPA is considered as the cardinal feature of ABPA regardless of the presence of preceding asthma or atopic predisposition.
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Affiliation(s)
- Naoki Okada
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Yoshiro Yamamoto
- Department of Mathematics, School of Science, Tokai University, Kanagawa, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Yoshiki Shiraishi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroto Matsuse
- Division of Respiratory Medicine, Department of Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Terufumi Shimoda
- Department of Allergy, Clinical Research Center, National Hospital Organization Fukuoka Hospital, Fukuoka, Japan
| | - Hirokazu Kimura
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Kentaro Watai
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
- Center for Immunology and Allergy, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Toshiyuki Harada
- Center for Respiratory Diseases, Japan Community Healthcare Organization Hokkaido Hospital, Sapporo, Japan
| | - Yuka Fujita
- Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Maho Suzukawa
- Clinical Research Center, National Hospital Organization Tokyo National Hospital, Kiyose, Japan
| | - Junko Suzuki
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Kiyose, Japan
| | - Noboru Takayanagi
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Kumagaya, Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Kumagaya, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Tomomatsu K, Yasuba H, Ishiguro T, Imokawa S, Hara J, Soeda S, Harada N, Tsurikisawa N, Oda N, Katoh S, Numata T, Sugino Y, Yamada M, Kamimura M, Terashima T, Okada N, Tanaka J, Oguma T, Asano K. Real-world efficacy of anti-IL-5 treatment in patients with allergic bronchopulmonary aspergillosis. Sci Rep 2023; 13:5468. [PMID: 37015988 PMCID: PMC10073186 DOI: 10.1038/s41598-023-32246-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/23/2023] [Indexed: 04/06/2023] Open
Abstract
Despite standard treatment with systemic corticosteroids and/or antifungal triazoles, a substantial proportion of patients with allergic bronchopulmonary aspergillosis (ABPA) experience frequent relapses and require long-term treatment despite unfavorable adverse effects. We investigated the efficacy and safety of anti-interleukin (IL)-5/IL-5 receptor α chain (Rα) monoclonal antibodies (mAbs) in patients with ABPA complicated by asthma. ABPA cases treated with anti-IL-5/IL-5Rα mAbs were collected from 132 medical institutes in 2018 and published case reports in Japan. Clinical outcomes, laboratory and physiological data, and radiographic findings during 32 weeks before and after treatment were retrospectively evaluated. We analyzed 29 cases of ABPA: 20 treated with mepolizumab and nine with benralizumab. Treatment with anti-IL-5/IL-5Rα mAbs reduced the frequency of exacerbations (p = 0.03), decreased the dose of oral corticosteroids (p < 0.01), and improved pulmonary function (p = 0.01). Mucus plugs in the bronchi shrank or diminished in 18 patients (82%). Despite the clinical/radiographical improvement, serum levels of total IgE, the key biomarker for the pharmacological response in ABPA, were unchanged. Anti-IL-5/IL-5Rα mAbs that directly target eosinophils are promising candidates for the treatment of patients with ABPA, especially those with mucus plugs in the bronchi.
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Affiliation(s)
- Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Hirotaka Yasuba
- Department of Airway Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
| | - Shiro Imokawa
- Department of Respiratory Medicine, Iwata City Hospital, Shizuoka, Japan
| | - Johsuke Hara
- Department of Respiratory Medicine, Kanazawa University Hospital, Ishikawa, Japan
| | - Seiko Soeda
- Department of Allergy and Respiratory Medicine, The Fraternity Memorial Hospital, Tokyo, Japan
| | - Norihiro Harada
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Naomi Tsurikisawa
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Naohiro Oda
- Department of Internal Medicine, Fukuyama City Hospital, Hiroshima, Japan
| | - Shigeki Katoh
- Department of General Medicine, Kawasaki Medical School, Okayama, Japan
| | - Takanori Numata
- Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuteru Sugino
- Department of Respiratory Medicine, Toyota Memorial Hospital, Aichi, Japan
| | - Mitsuhiro Yamada
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Mitsuhiro Kamimura
- Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Takeshi Terashima
- Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Naoki Okada
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
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Kimura Y, Tomomatsu K, Masaki K, Mizumura K, Wada Y, Tanimura K. [CQ IN THE LONG-TERM MANAGEMENT OF ADULT ASTHMATIC PATIENTS WHO ARE NOT ADEQUATELY CONTROLLED WITH INHALED CORTICOSTEROIDS MONOTHERAPY, WHICH IS MORE BENEFICIAL: ADDING A LONG ACTING BETA2 AGONIST OR A LONG ACTING MUSCARINIC ANTAGONIST?]. Arerugi 2023; 72:1158-1173. [PMID: 37967963 DOI: 10.15036/arerugi.72.1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Long-acting beta2-agonists (LABA) are preferred add-on treatment for adult asthmatic patients whose symptoms cannot be controlled with inhaled corticosteroids (ICS) alone. However, over the last decade, long-acting muscarinic antagonists (LAMA) have gained approval for use in treating asthma, and their efficacy is anticipated. Therefore, we conducted a systematic review to investigate whether the addition of LABA or LAMA is more beneficial for the long-term management of adult asthmatic patients poorly controlled on ICS monotherapy. We extracted eight relevant randomized controlled trials (represented in 18 articles) conducted by June 2022 form the corresponding Cochrane review and additional searches through medical databases (CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and ICHUSHI (https://www.jamas.or.jp/)). While the LAMA add-on group showed a significantly better improvement in some respiratory function tests, the difference between groups did not exceed the minimum clinically important difference (MCID). On the other hand, the Asthma Quality of Life Questionnaire, a quality of life metric, was significantly higher in the LABA add-on group, but the difference also did not surpass the MCID. Because no outcomes exceeded the MCID, we could not determine whether adding LABA or LAMA on ICS is more beneficial in the long-term management of adult asthmatic patients. Given that no significant differences were found in the incidence of adverse events (including serious ones), when specific adverse events associated with one treatment occur, switching to the other treatment (from LABA to LAMA, or vice versa) can be considered as an option.
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Affiliation(s)
- Yuya Kimura
- Clinical Research Center, National Hospital Organization Tokyo National Hospital
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine
| | - Kenji Mizumura
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine
| | - Yoshihisa Wada
- Pharmaceutical department, Osaka Habikino Medical Center
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Okada N, Shiraishi Y, Tomomatsu K, Oguma T, Asano K. Moldy odor from air conditioners in the residences of Japanese participants with and without asthma. Indoor Air 2022; 32:e13156. [PMID: 36437655 DOI: 10.1111/ina.13156] [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] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Fungi, a major allergen associated with asthma onset and severity, can contaminate air conditioners if not properly maintained. We surveyed the prevalence and risk factors associated with fungal contamination of air conditioners and patient behavior to reduce this contamination. Japanese adults aged ≥30 years registered in the database of an Internet research company were asked to participate in an online survey. A moldy odor from the air conditioners in their residences was used as an indicator of fungal contamination. Among a total of 1006 adults, including 631 patients with asthma, 37.1% reported a moldy odor from air conditioners. The prevalence was higher in residences with indoor condensation and in air conditioners used for ≥6 years or frequently during the summer, but was lower in air conditioners with an auto-cleaning function. The risk of indoor condensation was higher in apartments, in the presence of an aquarium, and in the absence of a 24-h ventilation system. These risk factors did not differ between the residences or air conditioners of participants with and without asthma. Asthmatic patients were conscious of indoor air quality; however, do not necessarily take appropriate measures to reduce indoor mold contamination, possibly due to a lack of knowledge. In conclusion, appropriate patient education is required to reduce environmental fungal contamination and improve asthma control.
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Affiliation(s)
- Naoki Okada
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Yoshiki Shiraishi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
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Horio Y, Takihara T, Takahashi F, Enokida K, Nakamura N, Tanaka J, Tomomatsu K, Niimi K, Tajiri S, Hayama N, Ito Y, Oguma T, Asano K. Prognosis of acute exacerbation in idiopathic pulmonary fibrosis with pulmonary emphysema: a retrospective cohort study in Japan. BMJ Open 2022; 12:e062236. [PMID: 36123101 PMCID: PMC9486357 DOI: 10.1136/bmjopen-2022-062236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To analyse the clinical characteristics and prognosis of acute exacerbation (AE) in patients with idiopathic pulmonary fibrosis (IPF) and pulmonary emphysema. DESIGN A multicentre retrospective cohort study SETTING: Two university hospitals in Japan PARTICIPANTS: Patients admitted to hospitals due to AE of IPF diagnosed based on a multidisciplinary discussion. INTERVENTIONS None PRIMARY AND SECONDARY OUTCOME MEASURES: 90-day mortality rate METHODS: We retrospectively analysed consecutive patients with AE of IPF, with or without pulmonary emphysema, admitted to two university hospitals between 2007 and 2018. RESULTS Among 62 patients (median age, 75 years; 48 men) admitted for AE of IPF, 29 patients (46%) presented with concomitant pulmonary emphysema. There was no significant difference in the arterial partial oxygen pressure/fraction of inhaled oxygen (P/F) ratio or other laboratory and radiographic data between patients with and without emphysema. The 90-day mortality rate was significantly lower in patients with emphysema than in those with IPF alone (23% vs 52%, p=0.03). The median survival time was significantly longer in patients with emphysema than in those with IPF alone (405 vs 242 days, p=0.02). CONCLUSION Patients with IPF and emphysema had better short-term survival after AE than those with non-emphysematous IPF.
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Affiliation(s)
- Yukihiro Horio
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Takahisa Takihara
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Fuminari Takahashi
- Department of Medicine, Tokai University Oiso Hospital, Naka-gun, Kanagawa, Japan
| | - Keito Enokida
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Noriko Nakamura
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Sakurako Tajiri
- Department of Medicine, Tokai University Oiso Hospital, Naka-gun, Kanagawa, Japan
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yoko Ito
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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Ono Y, Niimi K, Horio Y, Takihara T, Takahashi G, Harada K, Takiguchi H, Tomomatsu K, Hayama N, Oguma T, Aoki T, Urano T, Sekiguchi T, Koizumi J, Asano K. Trans-arterial Embolization in a Patient with Unilateral Absence of Pulmonary Artery: Treatment Success and the Four-year Prognosis. Intern Med 2022; 61:2343-2346. [PMID: 35022349 PMCID: PMC9424082 DOI: 10.2169/internalmedicine.8667-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Unilateral absence of the pulmonary artery (UAPA) with or without other anomalies in the heart is a rare congenital malformation. A 55-year-old Filipino woman without a remarkable medical history was admitted to our hospital for hemoptysis. Contrast-enhanced chest computed tomography revealed the absence of the left pulmonary artery. Echocardiography and right heart catheterization showed no cardiac malformations or pulmonary hypertension. We diagnosed her with isolated left-sided UAPA and performed transarterial embolization of the left inferior phrenic artery. This resolved the hemoptysis, and there was no recurrence during the four-year follow-up period.
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Affiliation(s)
- Yoshitaka Ono
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | - Yukihiro Horio
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | | | - Genki Takahashi
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | - Kazuki Harada
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | | | | | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | - Takuya Aoki
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | - Tetsuya Urano
- Division of Pulmonary Medicine, Department of Medicine, Japan
| | - Tatsuya Sekiguchi
- Department of Diagnostic Radiology, Tokai University School of Medicine, Japan
| | - Jun Koizumi
- Department of Diagnostic Radiology, Tokai University School of Medicine, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Japan
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10
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Hayama N, Takiguchi H, Enokida K, Hattori S, Takahashi G, Takeuchi T, Tanaka J, Horio Y, Tomomatsu K, Niimi K, Ito Y, Oguma T, Asano K. Efficacy of Prophylactic Antibiotic Use in Preventing Post-bronchoscopy Pneumonia in Lung Cancer Patients. Tokai J Exp Clin Med 2022; 47:56-59. [PMID: 35801548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Post-bronchoscopy pneumonia can affect the prognosis of lung cancer patients. This prospective study examined the efficacy of prophylactic antibiotics for lung cancer patients at high-risk of post-bronchoscopy pneumonia, determined by our prediction score, using three risk factors: age 70 years or older, current smoking, and central tumors visualized on CT. METHODS Patients with lung cancer who underwent diagnostic bronchoscopy between June 2018 and March 2020 with a score of 2 points or higher were enrolled. Sulbactam/ampicillin was administered intravenously within one hour prior to bronchoscopy, followed by oral clavulanate/amoxicillin for three days. We used the data of lung cancer patients who underwent diagnostic bronchoscopy between April 2012 and July 2014 and exhibited a score of 2 or higher as the historical control. RESULTS Post-bronchoscopy pneumonia occurred in none of the 24 patients in the prophylaxis group and in 17 of 144 patients in the control group, with no significant difference in the incidence of pneumonia between the two groups. CONCLUSIONS Antibiotic prophylaxis can be effective and safe for the patients high-risk of post-bronchoscopy pneumonia. A multicenter prospective study to examine the effects of prophylactic antibiotics in high-risk patients is feasible with a modest number of participants.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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11
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Abstract
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are common therapeutic agents for EGFR mutation-positive advanced non-small-cell lung cancer. There has been no report of rhabdomyolysis caused by an overdose of EGFR-TKIs. We herein review the existing literature on the subject and report a rare case of rhabdomyolysis due to an overdose of gefitinib, an EGFR-TKI.
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Affiliation(s)
- Shohei Obayashi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
| | - Mika Urata
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
| | - Yoko Ito
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
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12
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Yoshikawa T, Tomomatsu K, Okazaki E, Takeuchi T, Horio Y, Kondo Y, Oguma T, Asano K. COVID
‐19 vaccine‐associated organizing pneumonia. Respirol Case Rep 2022; 10:e0944. [PMID: 35386579 PMCID: PMC8965045 DOI: 10.1002/rcr2.944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/17/2022] [Accepted: 03/15/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Tomohiro Yoshikawa
- Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine Isehara Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine Isehara Japan
| | - Eriko Okazaki
- Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine Isehara Japan
| | - Tomoe Takeuchi
- Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine Isehara Japan
| | - Yukihiro Horio
- Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine Isehara Japan
| | - Yusuke Kondo
- Department of Pathology Tokai University School of Medicine Isehara Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine Isehara Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine Isehara Japan
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13
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Shiraishi Y, Kryukov K, Tomomatsu K, Sakamaki F, Inoue S, Nakagawa S, Imanishi T, Asano K. Diagnosis of pleural empyema/parapneumonic effusion by next-generation sequencing. Infect Dis (Lond) 2021; 53:450-459. [PMID: 33689538 DOI: 10.1080/23744235.2021.1892178] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Although a microbiological diagnosis of pleural infection is clinically important, it is often complicated by prior antibiotic treatment and/or difficulties with culturing some bacterial species. Therefore, we aimed to identify probable causative bacteria in pleural empyema/parapneumonic effusions by combining 16S ribosomal RNA (rRNA) gene amplification and next-generation sequencing (NGS). METHODS Pleural fluids were collected from 19 patients with infectious effusions and nine patients with non-infectious malignant effusions. We analysed DNA extracted from the pleural fluid supernatant by NGS using the Genome Search Toolkit and GenomeSync database, either directly or after PCR amplification of the 16S rRNA gene. Infectious and non-infectious effusions were distinguished by semi-quantitative PCR of the 16S rRNA gene. RESULTS Only 8 (42%) effusions were culture-positive, however, NGS of the 16S rRNA gene amplicon identified 14 anaerobes and 7 aerobes/facultative anaerobes in all patients, including Streptococcus sp. (n = 6), Fusobacterium sp. (n = 5), Porphyromonas sp. (n = 5), and Prevotella sp. (n = 4), accounting for >10% of the total genomes. The culture and NGS results were discordant for 3 out of 8 patients, all of whom had previously been treated with antibiotics. Total (2ΔCT value in semi-quantitative PCR of the 16S rRNA gene) and specific (total bacterial load multiplied by the proportion of primary bacteria in NGS) bacterial loads could efficiently distinguish empyema/parapneumonic effusion from non-infectious effusion. CONCLUSION Combining NGS with semi-quantitative PCR can facilitate the diagnosis of pleural empyema/parapneumonic effusion and its causal bacteria.
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Affiliation(s)
- Yoshiki Shiraishi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Kirill Kryukov
- Department of Molecular Life Science, Tokai University School of Medicine, Isehara, Japan.,Department of Genomics and Evolutionary Biology, National Institute of Genetics, Mishima, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Fumio Sakamaki
- Division of Respiratory Disease, Department of Medicine, Tokai University Hachioji Hospital, Tokyo, Japan
| | - Shigeaki Inoue
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara, Japan
| | - So Nakagawa
- Department of Molecular Life Science, Tokai University School of Medicine, Isehara, Japan
| | - Tadashi Imanishi
- Department of Molecular Life Science, Tokai University School of Medicine, Isehara, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Japan
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14
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Enokida K, Tomomatsu K, Okada N, Takeuchi T, Takihara T, Amaki J, Hayama N, Oguma T, Aoki T, Asano K. Transudative Pleural Effusion Associated with Extramedullary Hematopoiesis. Intern Med 2021; 60:449-452. [PMID: 32963151 PMCID: PMC7925273 DOI: 10.2169/internalmedicine.4668-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The authors report a case of transudative pleural effusion associated with extramedullary hematopoiesis due to the presence of a myeloproliferative neoplasm, which was unclassified. A 71-year-old man presented with right pleural effusion during an exacerbation of thrombocytosis. The pleural effusion was transudative, although there was no history of cardiac failure or hypoalbuminemia, and treatment with diuretics failed. Extramedullary hematopoiesis was diagnosed in bilateral paravertebral soft tissue and the liver on 111In bone marrow scintigraphy. The administration of hydroxyurea simultaneously reduced peripheral blood platelet count and pleural effusion within 2 weeks. The possible cause of transudative pleural effusion in association with extramedullary hematopoiesis is discussed.
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Affiliation(s)
- Keito Enokida
- Division of Pulmonary Medicine, Tokai University School of Medicine, Japan
| | | | - Naoki Okada
- Division of Pulmonary Medicine, Tokai University School of Medicine, Japan
| | - Tomoe Takeuchi
- Division of Pulmonary Medicine, Tokai University School of Medicine, Japan
| | - Takahisa Takihara
- Division of Pulmonary Medicine, Tokai University School of Medicine, Japan
| | - Jun Amaki
- Division of Hematology/Oncology, Department of Medicine, Tokai University School of Medicine, Japan
| | - Naoki Hayama
- Division of Pulmonary Medicine, Tokai University School of Medicine, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Tokai University School of Medicine, Japan
| | - Takuya Aoki
- Division of Pulmonary Medicine, Tokai University School of Medicine, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Tokai University School of Medicine, Japan
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15
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Hayama N, Hattori S, Takahashi G, Takahashi F, Takeuchi T, Tanaka J, Horio Y, Takiguchi H, Tomomatsu K, Kitahara A, Takihara T, Niimi K, Oguma T, Asano K. Cytokine/Chemokine/Growth Factor Levels in Malignant Pleural Effusion of Non-small Cell Lung Cancer. Tokai J Exp Clin Med 2020; 45:224-229. [PMID: 33300594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/07/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Malignant pleural effusions (MPEs) deteriorate the quality of life in patients with advanced stages of cancer. Although vascular endothelial growth factor (VEGF) is known to be a key factor for MPE formation, it is not fully clarified whether there are other components related to its appearance. METHODS Pleural effusion and serum samples were collected from patients with MPEs of non-small cell lung cancer. Cellular analysis of pleural effusion was performed using fluorescence flow cytometry. The concentrations of 12 cytokines, chemokines, and growth factors in MPEs and serum samples were analyzed using the cytometric bead array method. RESULTS Fifteen patients (median age: 70 years, 11 males) with non-small cell lung cancer (13 adenocarcinoma, 2 squamous cell carcinoma) were enrolled in this study. Concentrations of VEGF, interleukin (IL)-5, IL-6, IL-8, IL-12/IL-23p40, and C-C motif chemokine ligand (CCL) 2 were significantly higher in MPE than in serum. Pleural IL-5 levels correlated with malignant cell numbers in MPE. There was no factor related to the total amount of drained effusion or period of chest tube insertion. CONCLUSIONS Production of six molecules were increased in the pleural cavity with MPE of non-small cell lung cancer. Complex interactions among these molecules may regulate MPE formation.
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Affiliation(s)
- Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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16
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Kutsuzawa N, Takahashi F, Tomomatsu K, Obayashi S, Takeuchi T, Takihara T, Hayama N, Oguma T, Aoki T, Asano K. Successful Treatment of a Patient with Lung Adenocarcinoma Harboring Compound EGFR Gene Mutations, G719X and S768I, with Afatinib. Tokai J Exp Clin Med 2020; 45:113-116. [PMID: 32901897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
Mutations in the gene encoding epidermal growth factor receptor (EGFR) are the most frequent driver mutations in lung adenocarcinoma in Japan. Exon 19 deletion and L858R mutation in exon 21 are the most common EGFR mutations. Uncommon mutations, such as G719X, S768I, and L861Q, and compound mutations, combinations of 2 common or uncommon mutations, have also been reported. EGFR tyrosine kinase inhibitors (TKIs) are effective against cancers harboring common mutations; however, their efficacy against cancers with uncommon or compound mutations remains unclear. We report the case of a 67-year-old man with lung adenocarcinoma (clinical stage IIIA [cT1N2M0]), harboring an uncommon compound mutation, G719X and S768I. The cancer progressed within 2 months of initial chemoradiotherapy. Treatment with afatinib (40 mg/day) produced a partial response, which was maintained for 17 months with continued treatment. A literature review revealed that lung cancer with G719X/S768I compound mutation exhibited good response to EGFR-TKIs, even better than that of lung cancers with single uncommon mutations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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17
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Okada N, Oguma T, Shiraishi Y, Nishimura T, Hattori S, Tanaka J, Kitahara A, Tomomatsu K, Niimi K, Hayama N, Kamei K, Asano K. Repeated exacerbation by environmental exposure and spontaneous resolution of allergic bronchopulmonary mycosis. J Allergy Clin Immunol Pract 2020; 9:558-560.e1. [PMID: 32853818 DOI: 10.1016/j.jaip.2020.08.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Naoki Okada
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Yoshiki Shiraishi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Takuto Nishimura
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Shigeaki Hattori
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Asako Kitahara
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Katsuhiko Kamei
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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18
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Tomomatsu K, Oguma T, Baba T, Toyoshima M, Komase Y, Taniguchi M, Asano K. Effectiveness and Safety of Omalizumab in Patients with Allergic Bronchopulmonary Aspergillosis Complicated by Chronic Bacterial Infection in the Airways. Int Arch Allergy Immunol 2020; 181:499-506. [PMID: 32388510 DOI: 10.1159/000507216] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/13/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Allergic bronchopulmonary aspergillosis (ABPA) develops in the presence of predisposing conditions such as asthma and cystic fibrosis. Even ABPA accompanied by asthma is often complicated by chronic Pseudomonas aeruginosa or nontuberculous mycobacterial infection of the lower respiratory tract, rendering treatment with corticosteroids difficult. There have been several reports on the effectiveness of omalizumab, an anti-IgE antibody, in patients with ABPA. We analyzed the effectiveness and adverse effects of omalizumab in ABPA patients with chronic respiratory infections. METHODS Using our nationwide survey database and published case reports, we identified patients with severe asthma and ABPA who fulfilled the International Society for Human and Animal Mycology criteria and who had been treated with omalizumab. Exacerbation rates, control of symptoms, doses of oral corticosteroids, and pulmonary function were evaluated. RESULTS Among 25 patients with ABPA treated with omalizumab (median age 62 years, range 33-83 years), 12 patients had a chronic bacterial infection of the lower airways attributable to P. aeruginosa (n = 6) or nontuberculous mycobacteria (n = 6) at the initiation of omaliz-umab. Treatment with omalizumab reduced the frequency of exacerbations and systemic corticosteroid doses and improved pulmonary function. There were no significant adverse events or worsening of infection during treatment with omalizumab, except for injection-site reactions. CONCLUSIONS Treatment with omalizumab was effective and safe in patients with ABPA, regardless of comorbid chronic respiratory tract infections.
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Affiliation(s)
- Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tomohisa Baba
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Mikio Toyoshima
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Shizuoka, Japan
| | - Yuko Komase
- Department of Respiratory Medicine, Yokohama-City Seibu Hospital, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masami Taniguchi
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan,
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19
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Tanaka J, Hebisawa A, Oguma T, Tomomatsu K, Suzuki J, Shimizu H, Kawabata Y, Ishiguro T, Takayanagi N, Ueda S, Fukunaga K, Taniguchi M, Ono J, Ohta S, Izuhara K, Asano K. Evaluating serum periostin levels in allergic bronchopulmonary aspergillosis. Allergy 2020; 75:974-977. [PMID: 31715007 DOI: 10.1111/all.14114] [Citation(s) in RCA: 3] [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: 03/14/2019] [Revised: 10/20/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Jun Tanaka
- Division of Pulmonary Medicine Department of Medicine Tokai University School of Medicine Kanagawa Japan
| | - Akira Hebisawa
- Department of Laboratory Medicine National Hospital Organization Tokyo National Hospital Tokyo Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine Department of Medicine Tokai University School of Medicine Kanagawa Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine Department of Medicine Tokai University School of Medicine Kanagawa Japan
| | - Junko Suzuki
- Department of Pulmonary Medicine National Hospital Organization Tokyo National Hospital Tokyo Japan
| | - Hiroshige Shimizu
- Department of Laboratory Medicine National Hospital Organization Tokyo National Hospital Tokyo Japan
| | - Yoshinori Kawabata
- Division of Diagnostic Pathology Saitama Cardiovascular and Respiratory Center Saitama Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine Saitama Cardiovascular and Respiratory Center Saitama Japan
| | - Noboru Takayanagi
- Department of Respiratory Medicine Saitama Cardiovascular and Respiratory Center Saitama Japan
| | - Soichiro Ueda
- Division of Pulmonary Medicine Department of Medicine Keio University School of Medicine Tokyo Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine Department of Medicine Keio University School of Medicine Tokyo Japan
| | - Masami Taniguchi
- Clinical Research Center for Allergy and Rheumatology National Hospital Organization Sagamihara Hospital Kanagawa Japan
| | - Junya Ono
- Shino‐test Corporation Kanagawa Japan
| | - Shoichiro Ohta
- Department of Laboratory Medicine Saga Medical School Saga Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry Department of Biomolecular Sciences Saga Medical School Saga Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine Department of Medicine Tokai University School of Medicine Kanagawa Japan
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20
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Aoki T, Akiba T, Nishiyama J, Tajiri S, Hayama N, Takahashi G, Tanaka J, Sato M, Takiguchi H, Tomomatsu H, Tomomatsu K, Takihara T, Niimi K, Oguma T, Kohno M, Masuda R, Urano T, Itoh H, Kajiwara H, Nakamura N, Kunieda E, Matsumae M, Iwazaki M, Asano K. Analysis of key clinical features for achieving complete remission in stage III and IV non-small cell lung cancer patients. Respir Res 2019; 20:263. [PMID: 31752884 PMCID: PMC6873580 DOI: 10.1186/s12931-019-1235-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 09/01/2019] [Accepted: 11/07/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although development of immune checkpoint inhibitors and various molecular target agents has extended overall survival time (OS) in advanced non-small cell lung cancer (NSCLC), a complete cure remains rare. We aimed to identify features and treatment modalities of complete remission (CR) cases in stages III and IV NSCLC by analyzing long-term survivors whose OS exceeded 3 years. METHODS From our hospital database, 1,699 patients, registered as lung cancer between 1st Mar 2004 and 30th Apr 2011, were retrospectively examined. Stage III or IV histologically or cytologically confirmed NSCLC patients with chemotherapy initiated during this period were enrolled. A Cox proportion hazards regression model was used. Data collection was closed on 13th Feb 2017. RESULTS There were 164 stage III and 279 stage IV patients, including 37 (22.6%) and 51 (18.3%) long-term survivors and 12 (7.3%) and 5 (1.8%) CR patients, respectively. The long-term survivors were divided into three groups: 3 ≤ OS < 5 years, 5 years ≤ OS with tumor, and 5 years ≤ OS without tumor (CR). The median OS of these groups were 1,405, 2,238, and 2,876 days in stage III and 1,368, 2,503, and 2,643 days in stage IV, respectively. The mean chemotherapy cycle numbers were 16, 20, and 10 in stage III and 24, 25, and 5 in stage IV, respectively. In the stage III CR group, all patients received chemoradiation, all oligometastases were controlled by radiation, and none had brain metastases. Compared with non-CR patients, the stage IV CR patients had smaller primary tumors and fewer metastases, which were independent prognostic factors for OS among long-term survivors. The 80% stage IV CR patients received radiation or surgery for controlling primary tumors, and the surgery rate for oligometastases was high. Pathological findings in the stage IV CR patients revealed that numerous inflammatory cells existed around and inside resected lung and brain tumors, indicating strong immune response. CONCLUSIONS Multiple line chemotherapies with primary and oligometastatic controls by surgery and/or radiation might achieve cure in certain advanced NSCLC. Cure strategies must be changed according to stage III or IV. This study was retrospectively registered on 16th Jun 2019 in UMIN Clinical Trials Registry (number UMIN000037078).
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Affiliation(s)
- Takuya Aoki
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan.
| | - Takeshi Akiba
- Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Jun Nishiyama
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Sakurako Tajiri
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Naoki Hayama
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Genki Takahashi
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Jun Tanaka
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Masako Sato
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Hiroto Takiguchi
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Hiromi Tomomatsu
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Katsuyoshi Tomomatsu
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Takahisa Takihara
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Kyoko Niimi
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Tsuyoshi Oguma
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Mitsutomo Kohno
- Department of Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Ryota Masuda
- Department of Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Tetsuya Urano
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Hitoshi Itoh
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Hiroshi Kajiwara
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Etsuo Kunieda
- Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Mitsunori Matsumae
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Masayuki Iwazaki
- Department of Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Koichiro Asano
- Respiratory Division, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
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Kunimasa K, Ito K, Yamanaka T, Fujimoto D, Mori M, Maeno K, Tomomatsu K, Tamura A, Tanaka H, Watanabe S, Teraoka S, Hataji O, Suzuki K, Hontsu S, Hara S, Bessho A, Kubo A, Okuno M, Nakagawa K, Yamamoto N. The safety assessment of crizotinib and alectinib from real-world data of 840 ALK-inhibitor naïve patients with NSCLC harboring ALK-rearrangement (WJOG9516L). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Harada K, Oguma T, Saito A, Fukutomi Y, Tanaka J, Tomomatsu K, Taniguchi M, Asano K. Concordance between Aspergillus-specific precipitating antibody and IgG in allergic bronchopulmonary aspergillosis. Allergol Int 2018; 67S:S12-S17. [PMID: 29773475 DOI: 10.1016/j.alit.2018.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/02/2018] [Accepted: 04/21/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Several serological tests for specific precipitin or IgG are available to demonstrate type III hypersensitivity reactions to Aspergillus species and are essential for infectious fungal disease diagnosis. These assays are also important for allergic bronchopulmonary aspergillosis (ABPA) diagnosis; however, their concordance in ABPA was not well studied. METHODS Fifty-two ABPA patients diagnosed based on ISHAM criteria were enrolled. Precipitins and IgG specific to Aspergillus fumigatus, Aspergillus niger, Aspergillus flavus, or Aspergillus terreus were measured using Ouchterlony double immunodiffusion tests and ImmunoCAP method, respectively. A. fumigatus-specific IgG was also determined using complement-fixation (CF) method. RESULTS Forty-eight percent of cases were double-positive for A. fumigatus-specific precipitin and IgG (ImmunoCAP), whereas 3 (6%) and 14 (28%) cases were positive for precipitin or IgG alone, respectively. Kappa coefficient between these measurements was 0.32, suggesting poor concordance. Double-positive cases were more likely to present: Aspergillus sp. in sputum culture, lower pulmonary functions, peripheral blood eosinophilia, higher total IgE and A. fumigatus-specific IgG titer than precipitin-negative cases. A. fumigatus-specific IgG (CF) was positive only in 8 (15%) cases. The presence of A. fumigatus-specific precipitin or IgG was associated with antibodies specific for other Aspergillus spp., suggesting cross-reactivity. CONCLUSIONS Positive rate of A. fumigatus-specific precipitin or IgG (ImmunoCAP) was superior to IgG (CF), but relatively poor concordance was noted between precipitin and IgG (ImmunoCAP). Positive precipitin for A. fumigatus suggests more active diseases. Cross-reactivity may exist between antibodies to different Aspergillus spp. Therefore, the type III hypersensitivity results in ABPA diagnosis should be carefully evaluated.
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Affiliation(s)
- Kazuki Harada
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Akemi Saito
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Yuma Fukutomi
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Masami Taniguchi
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Takiguchi H, Takeuchi T, Niimi K, Tomomatsu H, Tomomatsu K, Hayama N, Oguma T, Aoki T, Urano T, Asai S, Miyachi H, Asano K. Proportion and clinical characteristics of non-asthmatic non-smokers among adults with airflow obstruction. PLoS One 2018; 13:e0196132. [PMID: 29742176 PMCID: PMC5942827 DOI: 10.1371/journal.pone.0196132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/08/2018] [Indexed: 12/01/2022] Open
Abstract
Background and objectives Chronic obstructive pulmonary disease (COPD) mainly develops after long-term exposure to cigarette or biomass fuel smoke, but also occurs in non-smokers with or without a history of asthma. We investigated the proportion and clinical characteristics of non-smokers among middle-aged to elderly subjects with airflow obstruction. Methods We retrospectively analyzed 1,892 subjects aged 40–89 years who underwent routine preoperative spirometry at a tertiary university hospital in Japan. Airflow obstruction was defined as a forced expiratory volume in 1 second (FEV1)/forced vital capacity < 0.7 or as the lower limit of the normal. Results Among 323 patients presenting with FEV1/forced vital capacity < 0.7, 43 had asthma and 280 did not. Among the non-asthmatic patients with airflow obstruction, 94 (34%) were non-smokers. A larger number of women than men with airflow obstruction had asthma (26% vs. 7.6%, p < 0.001), or were non-smokers among non-asthmatics (72% vs. 20%, p < 0.001). Non-asthmatic non-smokers, rather than non-asthmatic smokers, asthmatic non-smokers, and asthmatic smokers, exhibited better pulmonary function (median FEV1: 79% of predicted FEV1 vs. 73%, 69%, and 66%, respectively, p = 0.005) and less dyspnea on exertion (1% vs. 12%, 12%, and 28%, respectively, p = 0.001). Pulmonary emphysema on thoracic computed tomography was less common in non-smokers (p < 0.001). Using the lower limit of the normal to define airflow obstruction yielded similar results. Conclusions There are a substantial number of non-smokers with airflow obstruction compatible with COPD in Japan. In this study, airflow obstruction in non-smokers was more common in women and likelier to result in mild functional and pathological abnormalities than in smokers. Further studies are warranted to investigate the long-term prognosis and appropriate management of this population in developed countries, especially in women.
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Affiliation(s)
- Hiroto Takiguchi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tomoe Takeuchi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hiromi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Takuya Aoki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tetsuya Urano
- Division of Medical Education, Department of Basic Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Satomi Asai
- Department of Laboratory Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hayato Miyachi
- Department of Laboratory Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
- * E-mail:
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Oguma T, Taniguchi M, Shimoda T, Kamei K, Matsuse H, Hebisawa A, Takayanagi N, Konno S, Fukunaga K, Harada K, Tanaka J, Tomomatsu K, Asano K. Allergic bronchopulmonary aspergillosis in Japan: A nationwide survey. Allergol Int 2018; 67:79-84. [PMID: 28546015 DOI: 10.1016/j.alit.2017.04.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/02/2017] [Accepted: 04/13/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Allergic bronchopulmonary aspergillosis (ABPA) is an allergic pulmonary disease characterized by a hypersensitivity reaction to Aspergillus species colonizing the airways. The clinical characteristics of ABPA may differ depending on genetic and environmental background. We performed a nationwide survey to determine the clinical characteristics of ABPA in Japan. METHODS In 2013, a questionnaire on physician-diagnosed ABPA/allergic bronchopulmonary mycosis was sent to 903 medical centers specializing in respiratory or allergic diseases. Cases fulfilling the following criteria were categorized as possible ABPA-central bronchiectasis (ABPA-CB): 1) presence of specific serum immunoglobulin E (IgE) antibodies or a positive skin reaction to Aspergillus, and 2) bronchiectasis or mucoid impaction in the central bronchi. RESULTS Of 499 physician-diagnosed cases reported by 132 clinical centers, 358 cases met the criteria for possible ABPA-CB. Median age of ABPA-CB onset was 57 (interquartile range, 44-68) years; later-onset disease, developing ≥50 years of age, accounted for 66% of the cases and was associated with female sex, delayed onset of asthma, and lower levels of serum IgE. A third of the patients (120 patients, 34%) exhibited low levels of serum total IgE (<1000 IU/mL). Aspergillus species were isolated from sputum in 126/213 cases (59%), and Schizophyllum commune was identified in 12 (6%) patients. During the course of the treatment, ABPA recurred in 169 (48%) cases. CONCLUSIONS This nationwide survey identified several unique clinical characteristics of ABPA in Japan, such as late-onset, relatively lower serum IgE levels, and frequent recurrences/flares.
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Takiguchi H, Hayama N, Oguma T, Harada K, Sato M, Horio Y, Tanaka J, Tomomatsu H, Tomomatsu K, Takihara T, Niimi K, Nakagawa T, Masuda R, Aoki T, Urano T, Iwazaki M, Asano K. Post-bronchoscopy pneumonia in patients suffering from lung cancer: Development and validation of a risk prediction score. Respir Investig 2017; 55:212-218. [PMID: 28427748 DOI: 10.1016/j.resinv.2016.12.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 12/30/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND The incidence, risk factors, and consequences of pneumonia after flexible bronchoscopy in patients with lung cancer have not been studied in detail. METHODS We retrospectively analyzed the data from 237 patients with lung cancer who underwent diagnostic bronchoscopy between April 2012 and July 2013 (derivation sample) and 241 patients diagnosed between August 2013 and July 2014 (validation sample) in a tertiary referral hospital in Japan. A score predictive of post-bronchoscopy pneumonia was developed in the derivation sample and tested in the validation sample. RESULTS Pneumonia developed after bronchoscopy in 6.3% and 4.1% of patients in the derivation and validation samples, respectively. Patients who developed post-bronchoscopy pneumonia needed to change or cancel their planned cancer therapy more frequently than those without pneumonia (56% vs. 6%, p<0.001). Age ≥70 years, current smoking, and central location of the tumor were independent predictors of pneumonia, which we added to develop our predictive score. The incidence of pneumonia associated with scores=0, 1, and ≥2 was 0, 3.7, and 13.4% respectively in the derivation sample (p=0.003), and 0, 2.9, and 9.7% respectively in the validation sample (p=0.016). CONCLUSIONS The incidence of post-bronchoscopy pneumonia in patients with lung cancer was not rare and associated with adverse effects on the clinical course. A simple 3-point predictive score identified patients with lung cancer at high risk of post-bronchoscopy pneumonia prior to the procedure.
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Affiliation(s)
- Hiroto Takiguchi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Kazuki Harada
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Masako Sato
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Yukihiro Horio
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Hiromi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Takahisa Takihara
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Tomoki Nakagawa
- Department of Thoracic Surgery, Tokai University School of Medicine, Kanagawa, Japan.
| | - Ryota Masuda
- Department of Thoracic Surgery, Tokai University School of Medicine, Kanagawa, Japan.
| | - Takuya Aoki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Tetsuya Urano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Masayuki Iwazaki
- Department of Thoracic Surgery, Tokai University School of Medicine, Kanagawa, Japan.
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
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Oguma T, Nagaoka T, Kurahashi M, Kobayashi N, Yamamori S, Tsuji C, Takiguchi H, Niimi K, Tomomatsu H, Tomomatsu K, Hayama N, Aoki T, Urano T, Magatani K, Takeda S, Abe T, Asano K. Clinical contributions of exhaled volatile organic compounds in the diagnosis of lung cancer. PLoS One 2017; 12:e0174802. [PMID: 28384298 PMCID: PMC5383041 DOI: 10.1371/journal.pone.0174802] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 03/15/2017] [Indexed: 01/02/2023] Open
Abstract
Background Exhaled volatile organic compounds (VOC) are being considered as biomarkers for various lungs diseases, including cancer. However, the accurate measurement of extremely low concentrations of VOC in expired air is technically challenging. We evaluated the clinical contribution of exhaled VOC measured with a new, double cold-trap method in the diagnosis of lung cancer. Methods Breath samples were collected from 116 patients with histologically confirmed lung cancer and 37 healthy volunteers (controls) after inspiration of purified air, synthesized through a cold-trap system. The exhaled VOC, trapped in the same system, were heat extracted. We analyzed 14 VOC with gas chromatography. Results The concentrations of exhaled cyclohexane and xylene were significantly higher in patients with lung cancer than in controls (p = 0.002 and 0.0001, respectively), increased significantly with the progression of the clinical stage of cancer (both p < 0.001), and decreased significantly after successful treatment of 6 patients with small cell lung cancer (p = 0.06 and 0.03, respectively). Conclusion Measurements of exhaled VOCs by a double cold-trap method may help diagnose lung cancer and monitor its progression and regression.
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Affiliation(s)
- Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
- * E-mail:
| | - Takashi Nagaoka
- Research Institute for Science and Engineering, Waseda University, Tokyo, Japan
| | | | | | - Shinji Yamamori
- Ogino Memorial Laboratory, Nihon Kohden Corporation, Tokyo, Japan
| | - Chizuko Tsuji
- Department of Physiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroto Takiguchi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiromi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Takuya Aoki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tetsuya Urano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Kazushige Magatani
- Department of Electrical and Electronic Engineering, Tokai University School of Engineering, Kanagawa, Japan
| | - Sunao Takeda
- Research Institute for Science and Engineering, Waseda University, Tokyo, Japan
| | - Tadashi Abe
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Mochimaru T, Minematsu N, Ohsawa K, Tomomatsu K, Miura H, Betsuyaku T, Murakami M. Hemoperitoneum Secondary to Rupture of a Hepatic Metastasis from Small Cell Lung Cancer during Chemotherapy: A Case with a Literature Review. Intern Med 2017; 56:695-699. [PMID: 28321073 PMCID: PMC5410483 DOI: 10.2169/internalmedicine.56.6828] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 65-year-old man was diagnosed with small cell lung cancer with multiple liver metastases. Three days after initiating chemotherapy, he experienced abdominal discomfort with hypotension. Computed tomography revealed a ruptured liver metastasis and the presence of hemorrhagic ascites. Transcatheter arterial embolization to the appropriate hepatic artery in concomitant with supportive therapies successfully stabilized his condition. Unlike with hepatocellular carcinoma, the rupture of a liver metastasis and associated hemoperitoneum is very rare in patients with lung cancer. We comprehensively reviewed the literature and found 10 similar cases with this serious condition. Physicians should therefore be aware of the risk of hemoperitoneum caused by ruptured liver metastases in patients with lung cancer.
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Affiliation(s)
- Takao Mochimaru
- Department of Internal Medicine, Hino Municipal Hospital, Japan
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Aoki T, Nagaoka T, Kobayashi N, Kurahashi M, Tsuji C, Takiguchi H, Tomomatsu K, Oguma T, Kobayashi N, Magatani K, Takeda S, Asano K, Abe T. Prospective analyses of volatile organic compounds in obstructive sleep apnea patients. Toxicol Sci 2016; 156:362-374. [DOI: 10.1093/toxsci/kfw260] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Urano T, Hayama N, Tanaka J, Horio Y, Sato M, Hattori S, Takahashi G, Takahashi F, Takeuchi T, Harada K, Takiguchi H, Tomomatsu H, Tomomatsu K, Takihara T, Niimi K, Oguma T, Aoki T, Ogura G, Nakamura N, Asano K. Progressive Multifocal Micronodular Pneumocyte Hyperplasia in the Lungs of a Patient with Tuberous Sclerosis Complex: A Case Report. Tokai J Exp Clin Med 2016; 41:230-232. [PMID: 27988923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/03/2016] [Indexed: 06/06/2023]
Abstract
We report a case of multifocal micronodular pneumocyte hyperplasia (MMPH) in a patient with tuberous sclerosis complex, in whom the lung nodules increased in the number and size over the course of 8 years. We diagnosed MMPH following a lung biopsy performed during video-assisted thoracic surgery. In most of the previously reported cases, the number and size of lung nodules is unchanged during the clinical course. Our case is the first report of progressive disease in pathologically proven MMPH.
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Affiliation(s)
- Tetsuya Urano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Horio Y, Takihara T, Niimi K, Komatsu M, Sato M, Tanaka J, Takiguchi H, Tomomatsu H, Tomomatsu K, Hayama N, Oguma T, Aoki T, Urano T, Takagi A, Asano K. High-flow nasal cannula oxygen therapy for acute exacerbation of interstitial pneumonia: A case series. Respir Investig 2015; 54:125-9. [PMID: 26879483 DOI: 10.1016/j.resinv.2015.09.005] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/08/2015] [Accepted: 09/23/2015] [Indexed: 01/23/2023]
Abstract
We report 3 cases (all men, age: 69-81 years) of acute exacerbation of interstitial pneumonia (AEIP) that were successfully treated with a high-flow nasal cannula (HFNC), which delivers heated, humidified gas at a fraction of inspired oxygen (FIO2) up to 1.0 (100%). Oxygenation was insufficient under non-rebreathing face masks; however, the introduction of HFNC with an FIO2 of 0.7-1.0 (flow rate: 40 L/min) improved oxygenation and was well-tolerated until the partial pressure of oxygen in blood/FIO2 ratio increased (between 21 and 26 days). Thus, HFNC might be an effective and well-tolerated therapeutic addition to the management of AEIP.
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Affiliation(s)
- Yukihiro Horio
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Takahisa Takihara
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Masamichi Komatsu
- Division of General Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Masako Sato
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Jun Tanaka
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Hiroto Takiguchi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Hiromi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Takuya Aoki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Tetsuya Urano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Atsushi Takagi
- Division of General Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
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Oguma T, Morise M, Harada K, Tanaka J, Sato M, Horio Y, Takiguchi H, Tomomatsu H, Tomomatsu K, Takihara T, Niimi K, Hayama N, Aoki T, Urano T, Ito C, Koizumi J, Asano K. Pulmonary Artery Aneurysm/Pseudoaneurysm, a Delayed Complication of Lung Abscess: A Case Report. Tokai J Exp Clin Med 2015; 40:86-89. [PMID: 26369260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Massive hemoptysis mostly arises from the bronchial arteries; however, bleeding can also occur from a lesion in injured pulmonary arteries, such as pulmonary artery aneurysm/pseudoaneurysm (PAA/PAP), during pulmonary infection. CASE REPORT A 66-year-old man was admitted with a diagnosis of lung abscess in the right lower lobe that was complicated with pyothorax. Intravenous administration of antibiotics and thoracic drainage successfully controlled the infection and inflammation until day 16, when the patient began to exhibit hemoptysis and bloody pleural effusion. Enhanced computed tomography (CT) with multi-planer reconstruction (MPR) images showed a highly enhanced mass inside the abscess fed by the pulmonary artery, suggesting PAA/PAP. Pulmonary angiography confirmed PAA/PAP, and embolization with coils successfully stopped both the bleeding into the sputum and pleural effusion, with a collapsed aneurysm visible on chest CT scan. CONCLUSION Clinicians should consider the possibility of PAA/PAP in the differential diagnosis of hemoptysis during the treatment of patients with lung abscess. MPR CT is helpful for the diagnosis of PAA/PAP and its feeding vessels.
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Affiliation(s)
- Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Niimi K, Nagata E, Murata N, Sato M, Tanaka J, Horio Y, Takiguchi H, Tomomatsu H, Tomomatsu K, Hayama N, Oguma T, Aoki T, Urano T, Abe T, Inomoto C, Takizawa S, Asano K. Lung cancer associated with seronegative myasthenia gravis. Intern Med 2015; 54:1381-4. [PMID: 26027991 DOI: 10.2169/internalmedicine.54.3363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 64-year-old man presented with diplopia, muscle weakness, a pulmonary nodule and mediastinal widening on a chest radiograph. He was diagnosed with clinical stage IIIA (T2aN2M0) lung cancer. His neurological symptoms worsened following the initiation of thoracic radiation therapy (60 Gy) and chemotherapy. A diagnosis of myasthenia gravis (MG) was confirmed with a repetitive nerve stimulation test that showed a waning pattern, and a positive edrophonium test, although neither anti-acetylcholine receptor antibodies nor anti-muscle-specific tyrosine kinase antibodies were detected. The ptosis and limb muscle weakness improved with prednisolone and acetylcholinesterase inhibitor treatment, and a partial response of the lung cancer to chemoradiotherapy was obtained. However, the ptosis and limb muscle weakness worsened again following a recurrence of the lung cancer. The herein described case, in which lung cancer and MG occurred and recurred simultaneously, suggests that MG can develop as a paraneoplastic syndrome of lung cancer.
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Affiliation(s)
- Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan
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Takiguchi H, Niimi K, Tomomatsu H, Tomomatsu K, Hayama N, Oguma T, Aoki T, Urano T, Asai S, Miyachi H, Abe T, Asano K. Preoperative spirometry and perioperative drug therapy in patients with obstructive pulmonary dysfunction. Tokai J Exp Clin Med 2014; 39:151-157. [PMID: 25248432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/14/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The presence and severity of obstructive pulmonary diseases is important determinants of non-fatal and fatal postoperative complications. This study examined the characteristics of patients in need of perioperative drug therapy for obstructive pulmonary dysfunction. METHODS Among 2,358 surgical patients who, between September 2009 and February 2010, underwent spirometry at the Tokai University Hospital, the 333 whose forced expiratory volume in 1 second (FEV1) / forced vital capacity ratio was <0.7 were studied retrospectively. Single and multiple variable logistic regression analyses were performed in search of predictors of need for drug therapy. RESULTS Among the 230 men and 103 women (mean age = 68 ± 11 years) with obstructive pulmonary dysfunction, 108 (32%) received perioperative drug therapy with bronchodilators, inhaled corticosteroids or both. By multiple variable analysis, perioperative drug therapy was significantly correlated with a history of asthma and ever smoking, cough or sputum production, FEV1 <50% predicted, and emphysema, independently of consultations with pulmonologists. In a decision tree analysis, FEV1 and smoking history were the independent predictors of perioperative drug therapy. CONCLUSIONS Composite assessment of clinical history, respiratory symptoms, and pulmonary function is necessary for the efficient screening of the subjects who require perioperative drug therapy for obstructive pulmonary dysfunction.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Oguma T, Takiguchi H, Niimi K, Tomomatsu H, Tomomatsu K, Hayama N, Aoki T, Urano T, Nakano N, Ogura G, Nakagawa T, Masuda R, Iwazaki M, Abe T, Asano K. Endobronchial hamartoma as a cause of pneumonia. Am J Case Rep 2014; 15:388-92. [PMID: 25208559 PMCID: PMC4165510 DOI: 10.12659/ajcr.890869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Patient: Male, 66 Final Diagnosis: Endobronchial hamartoma Symptoms: Fever Medication: — Clinical Procedure: Flexible bronchoscopy • surgical resection Specialty: Pulmonology
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Affiliation(s)
- Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroto Takiguchi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiromi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Takuya Aoki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tetsuya Urano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Natsuko Nakano
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Go Ogura
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Tomoki Nakagawa
- General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Ryota Masuda
- General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Masayuki Iwazaki
- General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Tadashi Abe
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Tanaka K, Kamiishi N, Miyata J, Kabata H, Masaki K, Ogura-Tomomatsu H, Tomomatsu K, Suzuki Y, Fukunaga K, Sayama K, Betsuyaku T, Asano K. Determinants of Long-Term Persistence with Tiotropium Bromide for Chronic Obstructive Pulmonary Disease. COPD 2014; 12:233-9. [DOI: 10.3109/15412555.2014.933795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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36
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Miyata J, Fukunaga K, Iwamoto R, Isobe Y, Niimi K, Takamiya R, Takihara T, Tomomatsu K, Suzuki Y, Oguma T, Sayama K, Arai H, Betsuyaku T, Arita M, Asano K. Dysregulated synthesis of protectin D1 in eosinophils from patients with severe asthma. J Allergy Clin Immunol 2013; 131:353-60.e1-2. [DOI: 10.1016/j.jaci.2012.07.048] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 06/29/2012] [Accepted: 07/27/2012] [Indexed: 01/06/2023]
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Ogura-Tomomatsu H, Asano K, Tomomatsu K, Miyata J, Ohmori N, Kodama M, Ueda S, Takihara T, Tanaka K, Kamiishi N, Suzuki Y, Fukunaga K, Oguma T, Sayama K, Betsuyaku T. Predictors of osteoporosis and vertebral fractures in patients presenting with moderate-to-severe chronic obstructive lung disease. COPD 2012; 9:332-7. [PMID: 22489911 DOI: 10.3109/15412555.2012.667850] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Bone mineral density (BMD) alone does not reliably predict osteoporotic fractures. The Fracture Risk Assessment Tool (FRAX) was developed to estimate the risk of fracture in the general population. This study was designed to identify predictors of osteoporosis and vertebral fractures in patients presenting with chronic obstructive pulmonary disease (COPD). We studied 85 patients (mean age = 75 years; 92% men) with moderate to very severe COPD. Osteoporosis and vertebral fractures were diagnosed with dual energy X-ray absorptiometric scan and vertebral X-rays, respectively. Patient characteristics, including age, gender, body mass index (BMI), and results of pulmonary function tests, chest computed tomography scan, blood and urinary biomarkers of bone turnover were recorded, and a FRAX score was calculated by a computer-based algorithm. Osteoporosis, defined as a T score < -2.5, found in 20 patients (24%), was associated with female gender, BMI, dyspnea scale, long-term oxygen therapy (LTOT), vital capacity (VC), emphysema score on computed tomography, measurements of serum and urinary biomarkers of bone turnover. Vertebral fractures, diagnosed in 29 patients (35%), were strongly correlated with age, LTOT, VC, and forced expiratory volume in 1 sec, treatment with oral corticosteroid or warfarin, and weakly associated with the presence of osteoporosis. There was no correlation between FRAX score and prevalence of vertebral fractures, suggesting that neither BMD alone nor FRAX score would predict the presence of vertebral fractures in COPD patients. A disease-specific algorithm to predict osteoporotic fractures is needed to improve the management of patients suffering from COPD.
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Affiliation(s)
- Hiromi Ogura-Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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Miyazaki M, Naoki K, Sato T, Tanaka K, Tsuzuki K, Yoshida S, Tomomatsu K, Tasaka S, Soejima K, Sayama K, Asano K. [A case of advanced lung adenocarcinoma with cavity formation shrunken by bevacizumab added on the 3rd course of 6th-line chemotherapy]. Gan To Kagaku Ryoho 2012; 39:421-424. [PMID: 22421771] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 65-year-old man was pointed out to have an abnormal lung shadow by chest radiograph in a medical examination in 2007. An extensive examination diagnosed him as a case of advanced lung adenocarcinoma. He was treated by chemotherapy up to the 5th-line(cisplatin+docetaxel→CPT-11+S-1→amrubicin→gemcitabine+vinorelbine→pemetrexed), and the evaluation after the 5th-line treatment revealed disease progression. As he still maintained good performance status, the 6th- line treatment with carboplatin(AUC6, day 1)+paclitaxe(l 200mg/m2, day 1)(Q3W)was administered in March, 2010. The tumor size had been increasing slightly after 2 courses of chemotherapy, although it was within the range of stable disease. Therefore, bevacizumab(15mg/kg, day 1)was added after the 3rd course of treatment, and the tumor began shrinking obviously with cavity formation. Although the positioning of bevacizumab has not been established after 2nd-line treatment for advanced non-small cell lung carcinoma, we experienced a case of good tumor response by adding the bevacizumab in the middle of the 6th-line chemotherapy.
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Affiliation(s)
- Masaki Miyazaki
- Dept. of Internal Medicine, Keio University School of Medicine, Japan
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39
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Oguma T, Asano K, Tomomatsu K, Kodama M, Fukunaga K, Shiomi T, Ohmori N, Ueda S, Takihara T, Shiraishi Y, Sayama K, Kagawa S, Natori Y, Lilly CM, Satoh K, Makimura K, Ishizaka A. Induction of mucin and MUC5AC expression by the protease activity of Aspergillus fumigatus in airway epithelial cells. J Immunol 2011; 187:999-1005. [PMID: 21685325 DOI: 10.4049/jimmunol.1002257] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Allergic bronchopulmonary mycosis, characterized by excessive mucus secretion, airflow limitation, bronchiectasis, and peripheral blood eosinophilia, is predominantly caused by a fungal pathogen, Aspergillus fumigatus. Using DNA microarray analysis of NCI-H292 cells, a human bronchial epithelial cell line, stimulated with fungal extracts from A. fumigatus, Alternaria alternata, or Penicillium notatum, we identified a mucin-related MUC5AC as one of the genes, the expression of which was selectively induced by A. fumigatus. Quantitative RT-PCR, ELISA, and histochemical analyses confirmed an induction of mucin and MUC5AC expression by A. fumigatus extracts or the culture supernatant of live microorganisms in NCI-H292 cells and primary cultures of airway epithelial cells. The expression of MUC5AC induced by A. fumigatus extracts diminished in the presence of neutralizing Abs or of inhibitors of the epidermal growth factor receptor or its ligand, TGF-α. We also found that A. fumigatus extracts activated the TNF-α-converting enzyme (TACE), critical for the cleavage of membrane-bound pro-TGF-α, and its inhibition with low-molecular weight inhibitors or small interfering RNA suppressed the expression of MUC5AC. The protease activity of A. fumigatus extracts was greater than that of other fungal extracts, and treatment with a serine protease inhibitor, but not with a cysteine protease inhibitor, eliminated its ability to activate TACE or induce the expression of MUC5AC mRNA in NCI-H292. In conclusion, the prominent serine protease activity of A. fumigatus, which caused the overproduction of mucus by the bronchial epithelium via the activation of the TACE/TGF-α/epidermal growth factor receptor pathway, may be a pathogenetic mechanism of allergic bronchopulmonary mycosis.
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Affiliation(s)
- Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
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Kodama M, Asano K, Oguma T, Kagawa S, Tomomatsu K, Wakaki M, Takihara T, Ueda S, Ohmori N, Ogura H, Miyata J, Tanaka K, Kamiishi N, Fukunaga K, Sayama K, Ikeda E, Miyasho T, Ishizaka A. Strain-specific phenotypes of airway inflammation and bronchial hyperresponsiveness induced by epicutaneous allergen sensitization in BALB/c and C57BL/6 mice. Int Arch Allergy Immunol 2010; 152 Suppl 1:67-74. [PMID: 20523066 DOI: 10.1159/000312128] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Allergen sensitization through a disrupted skin barrier appears to play a prominent role in the development of atopic diseases, including allergic asthma. The role of the genetic background in immunological and physiological phenotypes induced by epicutaneous sensitization is undetermined. METHODS BALB/c and C57BL/6 mice were sensitized either epicutaneously by patch application of ovalbumin (OVA) or systemically by intraperitoneal injection of OVA with alum before exposure to aerosolized OVA. The concentrations of OVA-specific immunoglobulin in serum and cytokines in bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay. The severity of airway inflammation was evaluated by cell counts in BALF, and bronchial responsiveness to methacholine was measured by the flexiVent system. RESULTS The production of OVA-specific IgG1 and IgE was greater in the epicutaneously sensitized BALB/c than C57BL/6 mice. In contrast, both eosinophilic airway inflammation and bronchial responsiveness to methacholine were more prominent in the C57BL/6 than in the BALB/c mice. The concentrations of interleukin-4 increased significantly in the BALF from C57BL/6 mice only. No between-strain differences were observed after intraperitoneal sensitization. CONCLUSIONS The C57BL/6 mouse is a more appropriate model than the BALB/c mouse to study the relationship between skin barrier dysfunction and the pathogenesis of allergic asthma.
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Affiliation(s)
- Motohiro Kodama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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Miyata J, Asano K, Fukunaga K, Takihara T, Ohmari N, Kodama M, Tomomatsu K, Ogura H, Tanaka K, Kamiishi N, Niimi K, Oguma T, Sayama K, Takamiya R, Ishizaka A. Effects of Anti-inflammatory Lipid Mediator, Protectin D1, on Human Eosinophil Functions. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.718] [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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Abstract
Percutaneous cryotherapy (PCT) under computed tomographic guidance is minimally invasive, with satisfactory local control of primary lung cancer and pulmonary metastatic lesions. We report a case of acute respiratory distress syndrome (ARDS) in a patient who underwent PCT for lung metastasis of recurrent esophageal cancer. The patient responded to pulse steroid therapy and recovered from severe respiratory failure. Excessive inflammatory response to necrotic debris might contribute to the development of ARDS. To the best of our knowledge, this is the first report describing the details of ARDS following PCT.
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Affiliation(s)
- Sadatomo Tasaka
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo.
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Asano K, Nakade S, Oguma T, Fukunaga K, Ueda S, Horiuchi N, Kodama M, Ogura H, Tomomatsu K, Miyata J. Pharmacokinetic and Pharmacogenetic Analysis of Pranlukast in Japanese Adult Patients with Asthma. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.220] [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: 11/17/2022]
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Abstract
The blood pressure, electrocardiographic findings and serum total cholesterol of Tongans, characterized by extreme obesity, were compared with those of Japanese employees of a trading firm in Tokyo. The prevalence of cardiovascular diseases in Tongans as far as assessed by these measurements was rather low for their excessive obesity. It is unclear whether the relatively low prevalence rate of cardiovascular diseases among the Tongans is due to genetic factors which might be considered an ethnological difference, or to environmental factors. Reducing weight is very difficult for many obese people. Accordingly, if "healthy obesity" exists, elucidation of its mechanism will be glad tidings for obese persons. However, the most prevalent diseases among the Tongans were the same as those of the developing countries. Consequently, imitating the Tongan lifestyle does not necessarily assure the longevity of obese persons of developed nations, although it may decrease the risk of the cardiovascular diseases.
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Affiliation(s)
- S Sawata
- First Department of Internal Medicine, University of Tokyo, Japan
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Sawata S, Sato R, Hidaka H, Yasuda H, Tomomatsu K, Oka H. Relationship between alcohol consumption, body weight, family history of hypertension and blood pressure in young adults. Clin Exp Hypertens A 1986; 8:21-35. [PMID: 3708879 DOI: 10.3109/10641968609074761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
It is not clear why blood pressure rises with age in civilized countries. We examined the relationship between alcohol consumption, obesity, family history of hypertension and blood pressures at medical checkups in 534 male office workers, aged 20 to 40. The results in two age groups, 20-30 and 31-40, are as follows. Those who drank heavily (greater than 60 ml of ethanol) the previous night and/or habitual heavy drinkers (greater than 60 ml/day) had the highest blood pressure. Obese workers had higher blood pressure. Subjects with a family history of hypertension had higher blood pressure. The frequencies of heavy drinkers and obesity were higher in the group aged 31 to 40 than in the other group. These factors might contribute to the blood pressure elevation with age. 5) A histogram of the first readings of systolic blood pressure showed a bimodal distribution only in persons with a family history of hypertension.
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Sutou S, Yamamoto K, Sendota H, Tomomatsu K, Shimizu Y, Sugiyama M. Toxicity, fertility, teratogenicity, and dominant lethal tests in rats administered cadmium subchronically. I. Toxicity studies. Ecotoxicol Environ Saf 1980; 4:39-50. [PMID: 7379719 DOI: 10.1016/0147-6513(80)90006-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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47
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Sutou S, Uemura I, Tomomatsu K, Yamamoto K, Ichihara A, Nakabori H, Sano S. Mutagenicity of particulate air pollutants collected around Tokyo, Japan. Bull Environ Contam Toxicol 1980; 24:225-230. [PMID: 6988024 DOI: 10.1007/bf01608101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Okano M, Tomomatsu K, Kawai S, Katsuta R. [Results of treatment of temporomandibular joint disease with parotin]. Horumon To Rinsho 1973; 21:1061-6. [PMID: 4797010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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