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Ninomiya R, Nishijima T, Aoshima M, Sakaguchi H, Tokura Y. Sensory irritation to methylparaben is caused by its low metabolism in the skin. J Dermatol 2023. [PMID: 36949725 DOI: 10.1111/1346-8138.16775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/24/2023]
Abstract
Sensitive skin is a well- known skin condition showing sensory irritation to daily used products such as cosmetics or pharmaceuticals, possibly containing sensory irritants. Methylparaben (MP), widely used as a preservative, is a representative sensory irritant and hydrolyzed in the skin. We aimed to clarify the relationship between MP sensory irritation and MP hydrolysis. First, we investigated the percutaneous penetration and hydrolysis of MP by using an ex vivo pig skin system and confirmed that topically applied MP was immediately hydrolyzed to p-hydroxybenzoic acid (PHBA). We next evaluated whether MP or PHBA causes sensory irritation using a well-used stinging test in human skin and found that MP, but not PHBA, induced irritation. Additionally, MP, but not PHBA, increased intracellular calcium in cultured TRPA1-expressed HEK293 cells, supporting the stimulatory activity of MP. Five and 10 individuals with sensitive and non-sensitive skin, respectively, were selected by a questionnaire and stinging test. In their biopsied skin samples, MP hydrolytic activity was significantly lower in sensitive than non-sensitive skin. Finally, we examined the activity of carboxylesterase (CES), which promptly hydrolyzes MP to PHBA. By using specific inhibitors of CES and CES2, we found that CES1 was responsible for MP metabolism. Our study suggests that low skin metabolism of topical agents is one of the causes of skin sensory irritation and resultant sensitive skin.
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Affiliation(s)
- Rie Ninomiya
- Safety Science Research Laboratories, Kao Corporation, Odawara, Japan
| | | | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hitoshi Sakaguchi
- Safety Science Research Laboratories, Kao Corporation, Odawara, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Allergic Disease Research Center and Department of Dermatology & Skin Oncology, Chutoen General Medical Center, Kakegawa, Japan
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Abstract
Although nationwide immunization with SARS-CoV-2 mRNA vaccines began in February 2021, the evaluation of vaccine effectiveness (VE) using a test-negative design has not been conducted adequately in Japan. To evaluate the effectiveness of the SARS-CoV-2 mRNA vaccines, we conducted a test-negative case-control study during the periods dominated by the Delta and Omicron variants. In total, 518 and 358 adult participants with COVID-19-like symptoms were tested for the virus from August to October 2021 (Delta variant predominance) and in February 2022 (Omicron variant surge), at the Kawasaki Saiwai Clinic. During Delta variant predominance, the effectiveness of full vaccination was 90.4% (95% confidence interval [CI]: 82.1-94.8) and 97.3% (95% CI: 71.7-99.7) against all COVID-19 and moderate-to-severe disease, respectively. However, partial vaccination failed to show effectiveness against moderate-to-severe COVID-19. The effectiveness of the mRNA vaccines against all COVID-19 infection declined to 16.1% (95% CI: -81.0 to 61.1) in February 2022. Our results indicated that, although mRNA vaccines showed significant preventive effects against all COVID-19 during Delta variant predominance, these preventive effects waned during Omicron variant surge. To the best of our knowledge, this is the first study that evaluated VE in the Japanese population during both periods.
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Affiliation(s)
- Masahiro Aoshima
- Department of Pulmonology, Sekishinkai KawasakiSaiwai Clinick, Kawasaki, Japan,CONTACT Masahiro Aoshima Department of Pulmonology, Sekishinkai KawasakiSaiwai Clinick, 1-27-1 Minamisaiwai-cho, Saiwai-ku, Kawasaki212-0016, Japan
| | - Satoko Ohfuji
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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3
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Nakashima K, Suzuki K, Aoshima M, Murabata M, Kondo K, Ohfuji S, Fukushima W, Maeda A, Hirota Y. Effectiveness of the 23-valent pneumococcal polysaccharide vaccine against community-acquired pneumonia in older individuals after the introduction of childhood 13-valent pneumococcal conjugate vaccine: A multicenter hospital-based case-control study in Japan. Vaccine 2022; 40:6589-6598. [PMID: 36184405 DOI: 10.1016/j.vaccine.2022.09.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/30/2022] [Accepted: 09/17/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND In the era of childhood pneumococcal conjugate vaccine (PCV) immunization, especially 13-valent pneumococcal conjugate vaccine (PCV13) immunization, serotype replacement of Streptococcus pneumoniae and herd immunity in adults have been reported worldwide. Therefore, continuous evaluation of the effectiveness of the pneumococcal vaccine in adults is crucial because vaccine effectiveness may change owing to these factors. The purpose of this study was to evaluate the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) against all-cause pneumonia and pneumococcal pneumonia in older individuals with community-acquired pneumonia (CAP) after the introduction of childhood PCV13 in Japan, a topic that has remained largely unexplored. METHODS We evaluated pneumococcal vaccine effectiveness in this multicenter, matched case-control study conducted in hospitals and clinics. Cases included patients (aged ≥ 65 years) newly diagnosed with CAP between October 2016 and September 2019. A maximum of five non-pneumonia control patients matched for sex, school grade, date of outpatient visit, and medical institution were selected for each case. Conditional logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of pneumococcal vaccines for the occurrence of all-cause CAP and pneumococcal CAP. RESULTS The analysis included 740 individuals (142 patients and 598 controls). The median age of participants was 75 years (men: 54%). The adjusted OR for pneumococcal vaccination against all-cause CAP was 1.31 (95% CI: 0.84-2.06), while that for PPSV23 vaccination in the previous 5 years was 1.33 (95% CI: 0.85-2.09). The adjusted OR for PPSV23 vaccination in the previous 5 years against pneumococcal CAP was 0.93 (95% CI: 0.35-2.50). CONCLUSIONS This study was unable to demonstrate the effectiveness of PPSV23 against all-cause and pneumococcal pneumonia after the introduction of childhood PCV13 in Japan. Nonetheless, additional studies are needed to validate these results.
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Affiliation(s)
- Kei Nakashima
- Department of Pulmonology, Kameda Medical Center. Kamogawa, Chiba, Japan; Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Kanzo Suzuki
- Nagoya City University, School of Nursing, Nagoya, Japan; Department of Community-based Medical Education, Nagoya City Graduate School of Medical Sciences, Nagoya, Japan
| | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Center. Kamogawa, Chiba, Japan
| | - Mayumi Murabata
- Child Health Nursing, Course of Nursing Science, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Kyoko Kondo
- Management bureau, Osaka City University Hospital, Osaka, Japan
| | - Satoko Ohfuji
- Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan; Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Wakaba Fukushima
- Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan; Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Akiko Maeda
- Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yoshio Hirota
- Clinical Epidemiology Research Center, Medical Co. LTA, Fukuoka, Japan
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Maeda H, Gopal Dhoubhadel B, Sando E, Suzuki M, Furumoto A, Asoh N, Yaegashi M, Aoshima M, Ishida M, Hamaguchi S, Otsuka Y, Morimoto K. Long-term impact of pneumococcal conjugate vaccines for children on adult pneumococcal pneumonia in Japan: Two multicenter observational studies from 2011 to 2020. Vaccine 2022; 40:5504-5512. [PMID: 35963821 DOI: 10.1016/j.vaccine.2022.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pediatric pneumococcal conjugate vaccines (PCVs) introduction has directly and indirectly reduced pneumococcal pneumonia and invasive disease caused by PCV-covered serotypes among children and adults globally. In Japan, both PCV7 and PCV13 were introduced into the national immunization program (NIP) for children in 2013. However, the long-term impact of PCV use in children on adult pneumococcal pneumonia in Japan remains unclear. METHODS We assessed serotypes isolated from adult pneumococcal pneumonia patients (in- and outpatients) in two multicenter observational studies in Japan: 2011-2014 and 2016-2020. The latter study period was divided into two periods to evaluate changes after PCV introduction in children. The Quellung reaction was used to determine serotypes. We evaluated trends of individual and vaccine-covered serotypes over three periods and assessed the difference in changes by patient group before and after the introduction of pediatric PCVs. RESULTS A total of 650 patients were enrolled: 224, 322, and 104 in 2011-2014, 2016-2017, and 2018-2020, respectively. The median age was 73 years; 59.7% (388/650) were male; 86.9% (565/650) had comorbidities; and 10.2% (66/650) were nursing-home residents. The proportion of PCV13 serotypes decreased from 52.7% in 2011-2014 to 30.4% in 2016-2017 (p <0.001) after PCV13 introduction for children. However, PCV13, PCV15, and PCV20 serotypes still accounted for 38.5, 43.3, and 59.6% of total pneumococcal pneumonia in 2018-2020, respectively. Decline of PCV13 serotypes was more marked in patients aged ≥65 (-23.5%; p <0.001) than those aged <65 (-12.3%; p = 0.104) from 2011-2014 to 2016-2020. The proportion of PPSV23 non-PCV13 serotypes didn't change over time. CONCLUSIONS The proportion of adult pneumococcal pneumonia caused by PCV13 serotypes in Japan declined after pediatric PCVs introduction into NIP, possibly due to indirect effects of pediatric PCVs. However, use of new PCVs in Japanese adults may potentially prevent additional pneumococcal pneumonia cases. Now, pneumococcal vaccination strategy for older adults requires discussion.
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Affiliation(s)
- Haruka Maeda
- Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Clinical Tropical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Bhim Gopal Dhoubhadel
- Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Eiichiro Sando
- Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of General Internal Medicine and Clinical Infectious Diseases, Fukushima Medical University, Fukushima, Japan
| | - Motoi Suzuki
- Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Akitsugu Furumoto
- Department of Infectious Diseases, Nagasaki Rosai Hospital, Nagasaki, Japan
| | - Norichika Asoh
- Department of Internal Medicine, Juzenkai Hospital, Nagasaki, Japan
| | - Makito Yaegashi
- Department of General Internal Medicine, Kameda Medical Center, Chiba, Japan
| | | | - Masayuki Ishida
- Department of Respiratory Medicine, Chikamori Hospital, Kochi, Japan
| | - Sugihiro Hamaguchi
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yoshihito Otsuka
- Department of Laboratory Medicine, Kameda Medical Center, Chiba, Japan
| | - Konosuke Morimoto
- Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
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5
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Dhoubhadel BG, Suzuki M, Ishifuji T, Yaegashi M, Asoh N, Ishida M, Hamaguchi S, Aoshima M, Yasunami M, Ariyoshi K, Morimoto K. High prevalence of multiple serotypes of pneumococci in patients with pneumonia and their associated risk factors. Thorax 2022; 77:thoraxjnl-2021-217979. [PMID: 35474029 PMCID: PMC9606540 DOI: 10.1136/thoraxjnl-2021-217979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 04/03/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Multiple serotypes of pneumococci have epidemiological and clinical implications, such as the emergence of non-vaccine serotypes and the acquisition of antimicrobial resistance. Prevalence of multiple serotypes of pneumococci in adults and their risk factors are not known. METHODS We enrolled adult patients from age ≥15 years with radiologically confirmed pneumonia in four hospitals across Japan. Pneumococcal pneumonia was defined with a pneumococcal bacterial density of ≥104/mL in sputum by lytA quantitative PCR, and serotypes were determined. Pneumonias with a single serotype were categorised as single-serotype pneumococcal pneumonia and with two or more serotypes as multiple-serotype pneumococcal pneumonia. Multivariable logistic regression was used to assess the risk factors. RESULTS 3470 patients (median age 77 years, IQR 65-85) were enrolled. Pneumococcal pneumonia was identified in 476 (18.3%, n=2605) patients. Multiple serotypes were detected in 42% of them. Risk of having multiple serotypes was low among patients who had received 23-valent pneumococcal polysaccharide vaccine (PPSV23) vaccines (adjusted OR 0.51 (95% CI 0.27 to 0.94)). Proportion of non-PCV7 PPSV23 serotypes in overall distribution of multiple serotypes was 67.4% (n=324/481) compared with 46.4% (n=128/276) in that of single serotypes (p=0.001). Serotypes 5, 9N/9L, 10A, 12/22/46, 17F and 35F were associated with multiple-serotype pneumonia, and serotypes 6A/6B, 23F, 11 and 6C/6D were associated with single-serotype pneumonia. Proportion of more invasive serotypes (serotypes 1, 5, 7F, 8) was significantly higher in multiple-serotype pneumonia (p=0.001). CONCLUSIONS Multiple serotypes of pneumococci are common in sputum of adult patients with pneumonia. The risk of multiple-serotype pneumococcal pneumonia is lower than that of single-serotype pneumococcal pneumonia among PPSV23-vaccinated patients. TRIAL REGISTRATION NUMBER UMIN000006909.
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Affiliation(s)
- Bhim Gopal Dhoubhadel
- Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Motoi Suzuki
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomoko Ishifuji
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Makito Yaegashi
- Department of General Internal Medicine, Kameda Medical Center, Chiba, Japan
| | - Norichika Asoh
- Department of Internal Medicine, Juzenkai Hospital, Nagasaki, Japan
| | - Masayuki Ishida
- Department of Internal Medicine, Chikamori Hospital, Kochi, Japan
| | - Sugihiro Hamaguchi
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan
| | | | - Michio Yasunami
- Life Science Institute, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Koya Ariyoshi
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Konosuke Morimoto
- Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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6
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Nakashima K, Misawa M, Otsuki A, Narita K, Otsuka Y, Matsue K, Aoshima M. Efficacy and Safety of Endobronchial Ultrasonography with a Guide-sheath for Acute Pulmonary Lesions in Patients with Haematological Diseases. Intern Med 2022; 61:623-632. [PMID: 35228474 PMCID: PMC8943388 DOI: 10.2169/internalmedicine.6364-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective Acute pulmonary lesions (APLs), defined as an acute infiltrate or nodular lung field, are a major complication in patients with haematological diseases. Recently, endobronchial ultrasonography with a guide-sheath (EBUS-GS) was established as a useful technique for diagnosing pulmonary lesions. This study aimed to evaluate the efficacy and safety of EBUS-GS for managing APLs in patients with haematological diseases. Methods Our single-centre, retrospective, observational, single-arm, descriptive study enrolled 22 consecutive adult (>20-year-old) patients with haematological diseases and concomitant APL who underwent EBUS-GS between January 2011 and June 2016 at Kameda Medical Center, Chiba, Japan. The primary endpoint was the contribution of EBUS-GS to clinical decision-making. Secondary endpoints were an adequate tissue collection rate, diagnostic yield, complication rate, and 30-day mortality. Results The median patient age was 70 years old, and 63.6% were men. Acute myeloid leukaemia was the most frequent underlying disease, accounting for 54.5% of patients. The contribution of EBUS-GS to clinical decision-making was recognised in 11 (50.0%) patients. Adequate tissue collection was achieved in 21 (95.5%) patients. The aetiology of the APL was identified in 9 (40.9%) patients. No complications, including severe haemorrhaging and pneumothorax, were observed in any patients, and the 30-day mortality rate was 0%. Conclusion EBUS-GS may be a suitable diagnostic option for APL in patients with haematological diseases. Further larger-scale and randomised controlled trials are needed to confirm our results.
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Affiliation(s)
- Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, Japan
| | | | - Ayumu Otsuki
- Department of Pulmonology, Kameda Medical Center, Japan
| | | | | | - Kosei Matsue
- Department of Haematology, Kameda Medical Center, Japan
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Phadungsaksawasdi P, Kasuya A, Fukuchi K, Aoshima M, Nakazawa S, Suzuki T, Fujiyama T, Tokura Y, Honda T. Three-dimensional histological explanation of the dermoscopy patterns in acral melanocytic lesions. J Dermatol 2021; 48:1193-1200. [PMID: 33908083 DOI: 10.1111/1346-8138.15907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/15/2021] [Accepted: 03/29/2021] [Indexed: 12/01/2022]
Abstract
Dermoscopic images of pigmented lesions have distinct features on the sole where skin ridges and furrows exist. Pigmentation of benign nevus usually locates on the skin furrow, while the malignant melanoma is pigmented on the skin ridge. Correspondence between dermoscopy and pathology in the pigmented lesions on soles have been studied based on conventional vertical pathological images. However, for the full understanding of the correspondence, observation of horizontal histological images would be required, because the epidermis constructs unique horizontal structures, namely crista profunda limitans, crista profunda intermedia, and transverse ridge. In this study, we analyzed basic dermoscopic images of the representative acral melanocytic lesions (nevus, lentigo, and malignant melanoma) by horizonal histological images. We created serial horizontal pathological images by digital reconstruction of a hundred of serial vertical images. We could show that parallel furrow pattern is created by the pigmentation of crista profunda limitans, parallel ridge pattern by the pigmentation of both of crista profunda limitans and crista profunda intermediate, and lattice-like pattern by the pigmentation of transverse ridge. Our results would be useful for the intuitive histological understanding of dermoscopy.
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Affiliation(s)
| | - Akira Kasuya
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kensuke Fukuchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shinsuke Nakazawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takahiro Suzuki
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Toshiharu Fujiyama
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Cellular & Molecular Anatomy, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tetsuya Honda
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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8
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Nemoto M, Zaizen Y, Kataoka K, Kuroda K, Tabata K, Bychkov A, Sumikawa H, Johkoh T, Aoshima M, Kondoh Y, Fukuoka J. Histologic factors associated with nintedanib efficacy in patients with idiopathic pulmonary fibrosis. PLoS One 2021; 16:e0245147. [PMID: 33411718 PMCID: PMC7790243 DOI: 10.1371/journal.pone.0245147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/22/2020] [Indexed: 12/25/2022] Open
Abstract
Background Histopathologic factors predictive of nintedanib efficacy in idiopathic pulmonary fibrosis have not been studied. We aimed to describe the characteristics, focusing on histopathology, of idiopathic pulmonary fibrosis patients who did and did not respond to nintedanib. Methods This study retrospectively examined the clinicoradiopathologic features of 40 consecutive patients with surgical lung biopsy-confirmed idiopathic pulmonary fibrosis treated with nintedanib. Additionally, we compared the histopathologic scoring of 21 microscopic features between patients with functional or radiological progression and those with non-progression during 12 months of treatment. Results The histopathologic evaluation showed edematous changes in the interlobular septum as the only histologic finding observed more frequently in patients with both functional and radiological progression than in those without (58% vs. 14%, P = 0.007 and 50% vs. 0%, P = 0.003, respectively). Regarding per-year change, patients with edematous changes in the interlobular septum showed greater progression in median changes in spared area (-12%, interquartile range: [-25%–-5%], vs. -3% [-7%–0%], P = 0.004) and reticular shadow (7% [3%–13%], vs. 0% [0%–5%], P = 0.041) on computed tomography. Functional and radiological progression-free survival were shorter in patients with edematous changes in the interlobular septum than in those without (6.6 months, 95% confidence interval: [5.9–25.3], vs. event <50%, [12.1–Not available], P = 0.0009, and 6.1 months, [5.2–6.6] vs. 14.5 months [7.8–not available], P<0.0001). Conclusions Edematous changes in the interlobular septum may indicate poor nintedanib efficacy in idiopathic pulmonary fibrosis. Further studies are needed to validate these findings and address the mechanism behind ECIS.
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Affiliation(s)
- Masahiro Nemoto
- Department of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan
- Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshiaki Zaizen
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kensuke Kataoka
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan
| | - Kishio Kuroda
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiro Tabata
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Andrey Bychkov
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Pathology, Kameda Medical Center, Kamogawa, Japan
| | - Hiromitsu Sumikawa
- Department of Diagnostic Radiology, Sakai City Medical Center, Sakai, Japan
| | - Takeshi Johkoh
- Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Itami, Japan
| | - Masahiro Aoshima
- Department of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Pathology, Kameda Medical Center, Kamogawa, Japan
- * E-mail:
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9
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Nemoto M, Nakashima K, Noma S, Matsue Y, Yoshida K, Matsui H, Shiraishi A, Ishifuji T, Morimoto K, Ariyoshi K, Aoshima M. Prognostic value of chest computed tomography in community-acquired pneumonia patients. ERJ Open Res 2020; 6:00079-2020. [PMID: 33263023 PMCID: PMC7680909 DOI: 10.1183/23120541.00079-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/19/2020] [Indexed: 11/17/2022] Open
Abstract
Background Chest computed tomography (CT) is commonly used to diagnose pneumonia in Japan, but its usability in terms of prognostic predictability is not obvious. We modified CURB-65 (confusion, urea >7 mmol·L−1, respiratory rate ≥30 breaths·min−1, blood pressure <90 mmHg (systolic) ≤60 mmHg (diastolic), age ≥65 years) and A-DROP scores with CT information and evaluated their ability to predict mortality in community-acquired pneumonia patients. Methods This study was conducted using a prospective registry of the Adult Pneumonia Study Group – Japan. Of the 791 registry patients, 265 hospitalised patients with chest CT were evaluated. Chest CT-modified CURB-65 scores were developed with the first 30 study patients. The 30-day mortality predictability of CT-modified, chest radiography-modified and original CURB-65 scores were validated. Results In score development, infiltrates over four lobes and pleural effusion on CT added extra points to CURB-65 scores. The area under the curve for CT-modified CURB-65 scores was significantly higher than that of chest radiography-modified or original CURB-65 scores (both p<0.001). The optimal cut-off CT-modified CURB-65 score was ≥4 (positive-predictive value 80.8%; negative-predictive value 78.6%, for 30-day mortality). For sensitivity analyses, chest CT-modified A-DROP scores also demonstrated better prognostic value than did chest radiography-modified and original A-DROP scores. Poor physical status, chronic heart failure and multiple infiltration hampered chest radiography evaluation. Conclusion Chest CT modification of CURB-65 or A-DROP scores improved the prognostic predictability relative to the unmodified scores. In particular, in patients with poor physical status or chronic heart failure, CT findings have a significant advantage. Therefore, CT can be used to enhance prognosis prediction. Chest CT modification of CURB-65 and A-DROP improves prognosis prediction in community-acquired pneumonia. Patients with low physical status or chronic heart failure may have mismatch of chest CT and radiography findings.https://bit.ly/30GbNZS
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Affiliation(s)
- Masahiro Nemoto
- Dept of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan.,Dept of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kei Nakashima
- Dept of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Satoshi Noma
- Dept of Pulmonary Medicine, Shinkuki General Hospital, Kuki, Japan
| | - Yuya Matsue
- Dept of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Kazuki Yoshida
- Division of Rheumatology, Immunology and Allergy, Dept of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Hiroki Matsui
- Clinical Research Support Division, Kameda Institute for Health Science, Kameda College of Health Sciences, Kamogawa City, Japan
| | | | - Tomoko Ishifuji
- Dept of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Konosuke Morimoto
- Dept of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Koya Ariyoshi
- Dept of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Masahiro Aoshima
- Dept of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan
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Nemoto M, Nei Y, Bartholmai B, Yoshida K, Matsui H, Nakashita T, Motojima S, Aoshima M, Ryu JH. Automated computed tomography quantification of fibrosis predicts prognosis in combined pulmonary fibrosis and emphysema in a real-world setting: a single-centre, retrospective study. Respir Res 2020; 21:275. [PMID: 33081788 PMCID: PMC7576807 DOI: 10.1186/s12931-020-01545-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Combined pulmonary fibrosis and emphysema (CPFE) is a heterogeneous clinico-radiological syndrome without a consensus definition. There are limited data on the relation between the amount of parenchymal fibrosis and prognosis. In this study, we assessed the prognostic implications of the extent of fibrosis assessed by an automated quantitative computed tomography (CT) technique and the radiological and functional change over time in patients with a broad spectrum of fibrotic interstitial lung diseases (ILDs) encountered in a real-world setting. METHODS We conducted a single-centre, retrospective study of 228 consecutive patients with CPFE, encountered from 2007 to 2015 at Kameda Medical Center, Chiba, Japan. We investigated the prognostic value of automated CT fibrosis quantification and the subsequent course of CPFE. RESULTS Among 228 patients with CPFE, 89 had fibrosis affecting < 5% of their lungs, 54 had 5 to < 10% fibrosis, and 85 had ≥ 10% fibrosis at the time of diagnosis. Lower volume of fibrosis correlated with lower rates of mortality and acute exacerbation (p < 0.001). In particular, among those with < 5% fibrosis, only 4.5% died and none experienced acute exacerbation during follow-up, whereas 57.6% and 29.4% of those with ≥ 10% fibrosis experienced death and acute exacerbation, respectively. Although, the ≥ 10% fibrosis group had the poorest overall survival as well as the highest incidence of acute exacerbation, the incidence of decline in pulmonary function tests, change per year in total lung volume, and progression of fibrosis on chest CT was highest in the 5 to < 10% fibrosis group. The Cox proportional hazard model for CPFE progression (defined by composite criteria of death, acute exacerbation, and decline in forced vital capacity or diffusing capacity) showed fibrosis proportion was a risk factor independent of age, sex, smoking pack-years, the Charlson Comorbidity Index, lung cancer, connective tissue disease, and idiopathic pulmonary fibrosis. CONCLUSIONS Less severe (< 5%) fibrosis at baseline was associated with disease stability and better prognosis compared to more severe fibrosis in CPFE occurring with fibrotic ILDs. Further studies including a validation cohort will be needed. Trial Registration Retrospectively registered.
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Affiliation(s)
- Masahiro Nemoto
- Department of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan. .,Department of Immunology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba, Japan.
| | - Yuichiro Nei
- Department of Rheumatology, Teikyo University Chiba Medical Center, Ichihara, Japan
| | | | - Kazuki Yoshida
- Departments of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Hiroki Matsui
- Clinical Research Support Division, Kameda Institute for Health Science, Kameda College of Health Sciences, Kamogawa, Japan
| | - Tamao Nakashita
- Department of Rheumatology, Kameda Medical Center, Kamogawa, Japan
| | - Shinji Motojima
- Department of Rheumatology, Kameda Medical Center, Kamogawa, Japan
| | - Masahiro Aoshima
- Department of Immunology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba, Japan
| | - Jay H Ryu
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
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Taniguchi J, Nakashima K, Ito H, Tanaka Y, Otsuki A, Shiroshita A, Yoshimi M, Kubota N, Aoshima M. Pulmonary Sarcoidosis Presenting with Acute Respiratory Failure: A Report of a Case Diagnosed by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration on Ventilation after Intubation. Intern Med 2020; 59:2291-2295. [PMID: 32536645 PMCID: PMC7578599 DOI: 10.2169/internalmedicine.4624-20] [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: 11/22/2022] Open
Abstract
Sarcoidosis is a multisystem granulomatous disease of unknown etiology and is pathologically characterized by non-caseating granulomas in the organs involved. We herein report a case of sarcoidosis in a Japanese woman with acute respiratory failure, diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) on the ventilator after intubation. Only a few cases of previously undiagnosed sarcoidosis presenting acute respiratory failure have been reported. It is important to be aware that undiagnosed sarcoidosis may present with acute respiratory failure. Therefore, EBUS-TBNA under mechanical ventilation may be useful for the immediate diagnosis of patients.
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Affiliation(s)
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, Japan
| | - Hiroyuki Ito
- Department of Pulmonology, Kameda Medical Center, Japan
| | - Yu Tanaka
- Department of Pulmonology, Kameda Medical Center, Japan
| | - Ayumu Otsuki
- Department of Pulmonology, Kameda Medical Center, Japan
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12
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Hayashi K, Nakashima K, Noma S, Aoshima M, Kusanagi H. Laparoscopic surgery in patients with interstitial lung disease: A single-center retrospective observational cohort study. Asian J Endosc Surg 2020; 13:279-286. [PMID: 31691544 DOI: 10.1111/ases.12762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 08/11/2019] [Accepted: 10/06/2019] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Laparoscopic surgery requiring longer operative times and artificial pneumoperitoneum may affect pulmonary function; its feasibility in patients with interstitial lung disease remains unknown. Therefore, we examined the feasibility of laparoscopic surgery in patients with interstitial lung disease. METHODS We conducted a retrospective observational cohort study and examined the clinical data of patients with interstitial lung disease who had undergone abdominal surgery under general anesthesia. The primary end-point was the incidence of pulmonary complications. The secondary end-points were non-pulmonary complications and in-hospital mortality. RESULTS Twenty-nine patients who had undergone abdominal surgery were diagnosed with interstitial lung disease after a review of their clinical and imaging records. Laparoscopic surgery and open surgery were performed in 11 and 18 patients, respectively. Acute exacerbation occurred in one (9%) patient in the laparoscopic group and three patients (17%) in the open group; all had undergone emergency surgery. Postoperative pneumonia did not occur in any patients. Non-pulmonary complications occurred in one patient (9%) in the laparoscopic group and two patients (11%) in the open group. One patient in each group died of acute exacerbation during hospitalization. CONCLUSION Neither acute exacerbation nor pulmonary complications occurred after elective laparoscopic or open surgery in patients with interstitial lung disease. The risk of acute exacerbation after elective laparoscopic surgery may not be as high as that after elective thoracic surgery.
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Affiliation(s)
- Kentaro Hayashi
- Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa, Japan
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan
| | - Satoshi Noma
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan
| | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan
| | - Hiroshi Kusanagi
- Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa, Japan
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Umayahara T, Shimauchi T, Iwasaki M, Sakabe JI, Aoshima M, Nakazawa S, Yatagai T, Yamaguchi H, Phadungsaksawasdi P, Kurihara K, Tokura Y. Protective role of Galectin-7 for skin barrier impairment in atopic dermatitis. Clin Exp Allergy 2020; 50:922-931. [PMID: 32474952 PMCID: PMC7496409 DOI: 10.1111/cea.13672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 09/22/2019] [Revised: 05/02/2020] [Accepted: 05/20/2020] [Indexed: 12/17/2022]
Abstract
Background Atopic dermatitis (AD) patients have a barrier disorder in association with Th2 dominant skin inflammation. Galectin‐7 (Gal‐7), a soluble unglycosylated lectin, is highly expressed in the stratum corneum of AD patients. However, the biological significance of increased Gal‐7 expression in AD skin lesions remains unclear. Objective We aimed to investigate the production mechanism and functional role of Gal‐7 in AD patients and IL‐4/IL‐13–stimulated epidermal keratinocytes. Methods We assessed the Gal‐7 expression levels in skin lesions and sera from AD patients. Gal‐7 levels were also measured in monolayered normal human epidermal keratinocytes (NHEKs) and 3‐dimensional (3D)–reconstructed epidermis in the presence or absence of IL‐4/IL‐13 with or without Stat3, Stat6 or Gal‐7 gene silencing. Results Gal‐7 was highly expressed in the stratum corneum or intercellular space of AD lesional epidermis as assessed by the stratum corneum proteome analysis and immunohistochemistry. A positive correlation was noted between serum Gal‐7 level and transepidermal water loss in patients with AD. These clinical findings were corroborated by our in vitro data, which showed that IL‐4/IL‐13 facilitated the extracellular release of endogenous Gal‐7 in both monolayered NHEKs and 3D‐reconstructed epidermis. This machinery was caused by IL‐4/IL‐13–induced cell damage and inhibited by knockdown of Stat6 but not Stat3 in NHEKs. Moreover, we performed Gal‐7 knockdown experiment on 3D‐reconstructed epidermis and the result suggested that endogenous Gal‐7 serves as a protector from IL‐4/IL‐13–induced disruption of cell‐to‐cell adhesion and/or cell‐to‐extracellular matrix adhesion. Conclusion and Clinical Relevance Our study unveils the characteristic of Gal‐7 and its possible role as an alarmin that reflects the IL‐4/IL‐13–induced skin barrier impairment in AD.
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Affiliation(s)
- Takatsune Umayahara
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takatoshi Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Manami Iwasaki
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Jun-Ichi Sakabe
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shinsuke Nakazawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tsuyoshi Yatagai
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hayato Yamaguchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Kazuo Kurihara
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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14
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Shiroshita A, Matsui H, Yoshida K, Shiraishi A, Tanaka Y, Nakashima K, Aoshima M. Safety of the anterior approach versus the lateral approach for chest tube insertion by residents treating spontaneous pneumothorax: a propensity score weighted analysis. Gen Thorac Cardiovasc Surg 2020; 68:1425-1431. [PMID: 32519192 DOI: 10.1007/s11748-020-01403-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the risk of chest tube malposition, the most common complication during chest tube insertion, with the anterior or lateral approach for thoracostomy performed for patients with spontaneous pneumothorax by junior and senior residents. METHODS We retrospectively included patients aged ≥ 20 years who exhibited primary or secondary spontaneous pneumothorax without pleural adhesion and underwent chest tube drainage performed by junior or senior residents at tertiary care hospital. The study exposure involved insertion of the chest tube in the midclavicular line (anterior approach) or the anterior or midaxillary line (lateral approach). The primary outcome was the number of chest tube malpositions. Multiple imputation was used for missing data. The inverse probability of treatment weighting method was used to adjust for baseline confounders. RESULTS We identified 34 and 219 patients who underwent thoracostomy using the midclavicular and lateral approaches, respectively. The number of chest tube malpositions was 4 (11.8%) in the anterior approach and 34 (15.5%) in the lateral approach. The inverse probability of treatment weighting analysis revealed that the estimated odds ratio for chest tube malposition in the anterior approach group versus the lateral approach group was 0.61 (95% confidence interval, 0.17-2.11). The duration of chest tube drainage and the number of operations for persistent air leaks were not significantly different between the groups. CONCLUSIONS The current study revealed that the risk of chest tube malposition in thoracostomies with the midclavicular approach was not different from that with the lateral approach.
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Affiliation(s)
- Akihiro Shiroshita
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan. .,Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - Hiroki Matsui
- Clinical Research Support Division, Kameda Institute for Health Science, Kameda College of Health Science, Kamogawa, Japan
| | - Kazuki Yoshida
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - Atsushi Shiraishi
- Department of Emergency Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Yu Tanaka
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan
| | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan
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15
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Kondoh Y, Azuma A, Inoue Y, Ogura T, Sakamoto S, Tsushima K, Johkoh T, Fujimoto K, Ichikado K, Matsuzawa Y, Saito T, Kishi K, Tomii K, Sakamoto N, Aoshima M, Araya J, Izumi S, Arita M, Abe M, Yamauchi H, Shindoh J, Suda T, Okamoto M, Ebina M, Yamada Y, Tohda Y, Kawamura T, Taguchi Y, Ishii H, Hashimoto N, Abe S, Taniguchi H, Tagawa J, Bessho K, Yamamori N, Homma S. Thrombomodulin Alfa for Acute Exacerbation of Idiopathic Pulmonary Fibrosis. A Randomized, Double-Blind Placebo-controlled Trial. Am J Respir Crit Care Med 2020; 201:1110-1119. [DOI: 10.1164/rccm.201909-1818oc] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Aichi, Japan
| | - Arata Azuma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshikazu Inoue
- Clincal Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Takashi Ogura
- Division of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Susumu Sakamoto
- Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Kenji Tsushima
- Department of Pulmonary Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Takeshi Johkoh
- Department of Radiology, Kansai Rosai Hospital, Hyogo, Japan
| | | | - Kazuya Ichikado
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Yasuo Matsuzawa
- Department of Respiratory Medicine, Toho University Medical Center-Sakura Hospital, Chiba, Japan
| | - Takefumi Saito
- Department of Respiratory Medicine, National Hospital Organization, Ibarakihigashi National Hospital, Ibaraki, Japan
| | - Kazuma Kishi
- Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Jun Araya
- Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Machiko Arita
- Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama, Japan
| | - Mitsuhiro Abe
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroyoshi Yamauchi
- Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Joe Shindoh
- Department of Respiratory Medicine, Ogaki Municipal Hospital, Gifu, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Masaki Okamoto
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Masahito Ebina
- Department of Respiratory Medicine, Tohoku Medical and Pharmaceutical University, Miyagi, Japan
| | - Yoshihito Yamada
- Department of Respiratory Medicine, Japan Railway Tokyo General Hospital, Tokyo, Japan
| | - Yuji Tohda
- Department of Respiratory Medicine and Allergology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Tetsuji Kawamura
- Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, Hyogo, Japan
| | - Yoshio Taguchi
- Department of Respiratory Medicine, Tenri Hospital, Nara, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Naozumi Hashimoto
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Shinji Abe
- Department of Respiratory Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Hiroyuki Taniguchi
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Aichi, Japan
| | - Jun Tagawa
- Asahi-Kasei Pharma Corporation, Tokyo, Japan; and
| | - Koji Bessho
- Asahi-Kasei Pharma Corporation, Tokyo, Japan; and
| | | | - Sakae Homma
- Department of Advanced and Integrated Interstitial Lung Diseases Research, School of Medicine, Toho University, Tokyo, Japan
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16
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Sando E, Suzuki M, Furumoto A, Asoh N, Yaegashi M, Aoshima M, Ishida M, Hamaguchi S, Otsuka Y, Morimoto K. Corrigendum to “Impact of the pediatric 13-valent pneumococcal conjugate vaccine on serotype distribution and clinical characteristics of pneumococcal pneumonia in adults: The Japan Pneumococcal Vaccine Effectiveness Study (J-PAVE)” [Vaccine 37 (2019) 2687–2693]. Vaccine 2020; 38:3404. [DOI: 10.1016/j.vaccine.2020.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Fujiyama T, Umayahara T, Kurihara K, Shimauchi T, Ito T, Aoshima M, Otobe E, Hashizume H, Yagi H, Tokura Y. Skin Infiltration of Pathogenic Migratory and Resident T Cells Is Decreased by Secukinumab Treatment in Psoriasis. J Invest Dermatol 2020; 140:2073-2076.e6. [PMID: 32199992 DOI: 10.1016/j.jid.2020.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 02/03/2020] [Accepted: 02/24/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Toshiharu Fujiyama
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | - Takatsune Umayahara
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazuo Kurihara
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takatoshi Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taisuke Ito
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Emiko Otobe
- Clinical Research Center, Hamamatsu University School of Medicine Hamamatsu, Japan
| | - Hideo Hashizume
- Department of Dermatology, Shimada Municipal Hospital, Shizuoka, Japan
| | - Hiroaki Yagi
- Department of Dermatology, Shizuoka General Hospital, Shizuoka, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Abstract
Hepatitis B virus (HBV) is one of the main causes of polyarteritis nodosa (PAN). We herein report a rare case of HBV-associated vasculitis presenting with multiple pulmonary nodules, mimicking granulomatous polyangiitis (GPA), with no abnormalities of the ear, nose, or kidney. A surgical lung biopsy revealed geographic necrosis surrounded by palisading granuloma and capillaritis. Because the HBV surface antigen was positive with a serum HBV-DNA level of 2.9 log10 copies/mL, we first treated the patient with entecavir and 2 weeks of prednisone 50 mg/day. The pulmonary nodules resolved, and seroconversion was observed after one month.
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Affiliation(s)
- Masahiro Nemoto
- Department of Pulmonary Medicine, Kameda Medical Center, Japan
| | - Kenjin Nishioka
- Department of Pulmonary Medicine, Kameda Medical Center, Japan
| | - Jun Fukuoka
- Department of Pathology, Kameda Medical Center, Japan
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Japan
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19
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Shiroshita A, Uegami W, Otsuki A, Nakashima K, Sunagawa K, Fukuoka J, Kami S, Saito A, Aoshima M. A case of protein-losing gastroenteropathy caused by systemic AA amyloidosis secondary to undifferentiated carcinoma of unknown primary origin. Oxf Med Case Reports 2019; 2019:5545647. [PMID: 31398725 PMCID: PMC6688888 DOI: 10.1093/omcr/omz074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/15/2019] [Accepted: 06/24/2019] [Indexed: 11/25/2022] Open
Abstract
We report the case of a 61-year-old woman with Kartagener syndrome who presented with a 3-month history of chronic watery diarrhoea and severe hypoalbuminaemia. Histopathological examination of duodenum and large intestine biopsies showed amyloid A (AA) amyloid deposition. Scintigraphy and alpha-1 anti-trypsin clearance evaluations revealed protein-losing gastroenteropathy. Computed tomography with contrast and positron emission tomography showed a pelvic mass with multiple para-aortic lymph node enlargement. We suspected protein-losing gastroenteropathy secondary to AA amyloid produced related to malignant tumours. Following tumour resection, histopathological examination of the lesion revealed undifferentiated carcinoma of unknown origin. Postoperatively, the patient’s nutritional condition improved. There has been no recurrence of protein-losing gastroenteropathy 6 months postoperatively. This is the first report of protein-losing gastroenteropathy and AA amyloidosis secondary to undifferentiated carcinoma. Early recognition and intervention could increase the likelihood of amyloidosis remission.
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Affiliation(s)
- Akihiro Shiroshita
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
| | - Wataru Uegami
- Department of Anatomic Pathology, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
| | - Ayumu Otsuki
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
| | - Keishin Sunagawa
- Department of Anatomic Pathology, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
| | - Junya Fukuoka
- Department of Anatomic Pathology, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
| | - Shota Kami
- Postgraduate Clinical Training Center, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
| | - Ayumi Saito
- Department of Medical Oncology, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
| | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa 296-8602, Chiba Prefecture, Japan
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20
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Aoshima M, Phadungsaksawasdi P, Nakazawa S, Iwasaki M, Sakabe JI, Umayahara T, Yatagai T, Ikeya S, Shimauchi T, Tokura Y. Decreased expression of suprabasin induces aberrant differentiation and apoptosis of epidermal keratinocytes: Possible role for atopic dermatitis. J Dermatol Sci 2019; 95:107-112. [PMID: 31399284 DOI: 10.1016/j.jdermsci.2019.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/16/2019] [Accepted: 07/22/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Suprabasin (SBSN), a secreted protein, is expressed in various epithelial tissues. The role of SBSN in epidermal differentiation and atopic dermatitis (AD) pathology remains largely unknown. OBJECTIVE To evaluate the effects of SBSN on epidermal keratinocytes and its role in AD. METHODS We examined the SBSN expression levels in the stratum corneum and the epidermis by proteome analysis and immunohistochemistry, respectively. The serum SBSN concentration was measured by ELISA. These values were compared between AD and healthy control. Morphological changes in the epidermis were investigated in SBSN-knockdown three-dimensional human living skin equivalent (LSE) model with or without IL-4/IL-13. RESULTS Epidermal SBSN expression was decreased in AD lesional skin compared to healthy skin, as assessed by the stratum corneum proteome analysis and immunohistochemistry. The SBSN serum levels were significantly lower in AD patients than in normal subjects (P<0.05). The SBSN-deficient LSE exhibited compact stratum corneum, immature stratum granulosum, and increased keratinocyte apoptosis. Th2 cytokines, IL-4 and IL-13, did not affect SBSN expression in LSE. There were no differentiation-associated makers that were affected by the SBSN knockdown. SBSN deficiency-induced apoptosis of keratinocytes was exaggerated by IL-4/IL-13, and accordingly, the addition of recombinant SBSN induced significant keratinocyte proliferation (P<0.05). CONCLUSION Our data demonstrated that SBSN regulates normal epidermal barrier. Th2 cytokines unaffect SBSN expression in keratinocytes, but promote SBSN deficiency-induced apoptosis. It is suggested that SBSN has an anti-apoptotic activity, and its deficiency is involved in the pathogenesis of AD.
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Affiliation(s)
- Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Shinsuke Nakazawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Manami Iwasaki
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Jun-Ichi Sakabe
- Institute of Molecular and Cell Biology, Agency for Science, Technology, and Research, Singapore
| | - Takatsune Umayahara
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tsuyoshi Yatagai
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shigeki Ikeya
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takatoshi Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
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21
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Goto Y, Suzuki T, Suzuki Y, Anzawa K, Mochizuki T, Tamura T, Makimura K, Aoshima M, Ito T, Tokura Y. Trichophyton tonsurans-induced kerion celsi with decreased defensin expression and paradoxically increased interleukin-17A production. J Dermatol 2019; 46:794-797. [PMID: 31294481 DOI: 10.1111/1346-8138.15008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/07/2019] [Indexed: 12/24/2022]
Abstract
We report a case of kerion celsi due to Trichophyton tonsurans. An 18-year-old male student judo practitioner had alopecic patches, black dots and subcutaneous abscesses on the right temporal region. The damaged hair represented endothrix infection with T. tonsurans, as assessed by mycological examinations. He was treated with oral itraconazole without any therapeutic effect, followed by terbinafine with good effect. A skin biopsy showed neutrophil, lymphocyte and histiocyte infiltration into the dermis and subcutaneous tissue with abscesses around a number of dilated hair follicles. Immunostaining showed that the expression level of human β-defensin 2 (HBD-2) was decreased in the epidermis of the alopecic and adjacent skin. Because interleukin (IL)-17A generally induces HBD-2 production by epidermal keratinocytes, we also immunohistochemically investigated IL-17A expression. Unexpectedly, many IL-17A-bearing cells were found around destructed hair follicles, indicating that IL-17A expression was not attenuated, but rather increased in the skin lesion. Our case suggests that IL-17A-upregulated antimicrobial peptide expression is disordered in kerion celsi, and severe inflammation with IL-17A may cause tissue damage and resultant scar.
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Affiliation(s)
- Yoshihiro Goto
- Division of Dermatology, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Takahiro Suzuki
- Division of Dermatology, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Yoko Suzuki
- Division of Dermatology, Shizuoka Municipal Hospital, Shizuoka, Japan
| | - Kazushi Anzawa
- Department of Dermatology, Kanazawa Medical University, Kanazawa, Japan
| | - Takashi Mochizuki
- Department of Dermatology, Kanazawa Medical University, Kanazawa, Japan
| | - Takashi Tamura
- General Medical Education and Research Center, Teikyo University, Tokyo, Japan
| | - Koichi Makimura
- Medical Mycology, Graduate School of Medicine, Teikyo University, Tokyo, Japan
| | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taisuke Ito
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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22
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Kasuya A, Aoshima M, Fukuchi K, Shimauchi T, Fujiyama T, Tokura Y. Digitally reconstructed top‐down view images provide intuitive understanding of the correlation between dermoscopy and histopathology: a good educational tool. Br J Dermatol 2019; 181:606-607. [DOI: 10.1111/bjd.17819] [Citation(s) in RCA: 4] [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] [Indexed: 01/21/2023]
Affiliation(s)
- A. Kasuya
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - M. Aoshima
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - K. Fukuchi
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - T. Shimauchi
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - T. Fujiyama
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Y. Tokura
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
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23
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Goto H, Shimauchi T, Fukuchi K, Yokota N, Koizumi S, Aoshima M, Endo Y, Masuda Y, Miyazawa H, Kasuya A, Nakamura K, Ito T, Tokura Y. Therapeutic Effectiveness of Immunoradiotherapy on Brain-metastatic BRAF/MEK Inhibitor-resistant Melanoma with Balloon Cell Change. Acta Derm Venereol 2019; 99:612-613. [PMID: 30673109 DOI: 10.2340/00015555-3134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Haruka Goto
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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24
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Goto H, Shimauchi T, Fukuchi K, Yokota N, Koizumi S, Aoshima M, Endo Y, Masuda Y, Miyazawa H, Kasuya A, Nakamura K, Ito T, Tokura Y. Therapeutic Effectiveness of Immunoradiotherapy on Brain-metastatic BRAF/MEK Inhibitor-resistant Melanoma with Balloon Cell Change. Acta Derm Venereol 2019. [PMID: 30673109 DOI: 10.2340/00015555-3134.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Haruka Goto
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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25
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Shimauchi T, Umayahara T, Iwasaki M, Aoshima M, Nakazawa S, Tokura Y. 324 A potential role of galectin-7 as a stabilizer for IL-4/IL-13-induced barrier disruption in atopic dermatitis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Pulmonary tumor thrombotic microangiopathy (PTTM) is a complication characterized by dyspnea, pulmonary hypertension, and occasionally sudden death. We encountered a man who developed PTTM and had an inhalation history of chemical herbicides and abnormal findings on chest computed tomography, mimicking chemical inhalation lung injury. He was diagnosed with PTTM with adenocarcinoma by a transbronchial lung biopsy and received chemotherapy and anticoagulant therapy. He survived for one month. An autopsy revealed primary gastric cancer with PTTM that can have a presentation similar to diffuse pulmonary diseases, including chemical inhalation lung injury. The examination of a biopsy specimen is crucial in such patients.
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Affiliation(s)
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, Japan
| | - Kazuei Hoshi
- Department of Pathology, Kameda Medical Center, Japan
| | - Yu Oyama
- Department of Oncology Medicine, Kameda Medical Center, Japan
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27
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Fukuchi K, Hikawa M, Sano Y, Kasuya A, Aoshima M, Tatsuno K, Nakamura Y, Kosugi I, Tokura Y. Sarcoid‐like reaction and vitiligo occurring after nivolumab therapy in a patient with metastatic melanoma. J Dermatol 2019; 46:e359-e360. [DOI: 10.1111/1346-8138.14887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Kensuke Fukuchi
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Miho Hikawa
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Yusuke Sano
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Akira Kasuya
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Masahiro Aoshima
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Kazuki Tatsuno
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Yutaro Nakamura
- Department of Respiratory Medicine Hamamatsu University School of Medicine Hamamatsu Japan
| | - Isao Kosugi
- Department of Pathology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Yoshiki Tokura
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
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28
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Sando E, Suzuki M, Furumoto A, Asoh N, Yaegashi M, Aoshima M, Ishida M, Hamaguchi S, Otsuka Y, Morimoto K. Impact of the pediatric 13-valent pneumococcal conjugate vaccine on serotype distribution and clinical characteristics of pneumococcal pneumonia in adults: The Japan Pneumococcal Vaccine Effectiveness Study (J-PAVE). Vaccine 2019; 37:2687-2693. [PMID: 30975569 DOI: 10.1016/j.vaccine.2019.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/02/2019] [Accepted: 04/04/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The pediatric 13-valent pneumococcal conjugate vaccine (PCV13) was included in the pediatric immunization programme in Japan in late 2013. The impact of vaccination on the serotype distribution and clinical characteristics of pneumococcal pneumonia has not been described. METHODS The first phase of this multicentre prospective study was conducted at community-based hospitals in Japan from 2011 to 2014. The second phase was conducted from 2016 to 2017. Pneumococcal isolates and clinical data were collected from patients with community-acquired pneumonia who were ≥15 years of age. Patients were classified by pneumococcal serotype to PCV13 serotype, 23-valent pneumococcal polysaccharide vaccine (PPV23) non-PCV13 serotype, and non-vaccine serotype. RESULTS A total of 484 patients were enrolled, 241 in the first phase and 243 in the second. The proportion of PCV13 serotypes decreased from 53% to 33% (p < 0.001), whereas PPV23 non-PCV13 serotypes did not change (p = 0.754). PCV13 serotypes were associated with increased risk of elevated blood urea nitrogen (adjusted odds ratio 2.49; 95% confidence interval: 1.49-4.16) and hospitalization (adjusted odds ratio 1.74; 95% confidence interval: 1.02-2.95). These associations were not observed in patients with PPV23 non-PCV13 serotypes. CONCLUSIONS The occurrence of pneumococcal pneumonia caused by vaccine-covered serotypes dramatically decreased following the introduction of pediatric PCV13. The PCV13 serotypes were associated with pneumonia severity.
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Affiliation(s)
- Eiichiro Sando
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Clinical Tropical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of General Internal Medicine, Kameda Medical Center, Chiba, Japan
| | - Motoi Suzuki
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Akitsugu Furumoto
- Department of Infectious Diseases, Nagasaki Rosai Hospital, Nagasaki, Japan
| | - Norichika Asoh
- Department of Internal Medicine, Juzenkai Hospital, Nagasaki, Japan
| | - Makito Yaegashi
- Department of General Internal Medicine, Kameda Medical Center, Chiba, Japan
| | | | - Masayuki Ishida
- Department of Respiratory Medicine, Chikamori Hospital, Kochi, Japan
| | - Sugihiro Hamaguchi
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yoshihito Otsuka
- Department of Laboratory Medicine, Kameda Medical Center, Chiba, Japan
| | - Konosuke Morimoto
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Clinical Tropical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
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29
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Miyazawa H, Shimauchi T, Hashizume H, Masuda Y, Aoshima M, Ito T, Tokura Y. Voriconazole-photoinduced polyomavirus-negative Merkel cell carcinoma. J Dermatol 2019; 46:e287-e288. [PMID: 30859619 DOI: 10.1111/1346-8138.14849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Hidehiko Miyazawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takatoshi Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideo Hashizume
- Department of Dermatology, Shimada Municipal Hospital, Shimada, Japan
| | - Yurika Masuda
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taisuke Ito
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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30
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Hanai S, Shimauchi T, Kageyama R, Aoshima M, Ito T, Tokura Y. Unknown primary Merkel cell carcinoma responding well to first-line treatment with avelumab. J Dermatol 2019; 46:e273-e275. [PMID: 30802319 DOI: 10.1111/1346-8138.14827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Shiho Hanai
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takatoshi Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Reiko Kageyama
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taisuke Ito
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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31
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Hanai S, Aoshima M, Yagyu R, Tokura Y. Cholinergic urticaria with angioedema successfully treated with omalizumab. J Cutan Immunol Allergy 2019. [DOI: 10.1002/cia2.12042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Shiho Hanai
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | | | | | - Yoshiki Tokura
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
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32
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Yamada M, Nakashima K, Ito H, Aoshima M. Severe acute respiratory failure due to Sai-rei-to-induced lung injury successfully treated by multi-modal therapy including immunosuppressive therapy, plasma exchange, and intravenous immunoglobulin: A case report. Respir Med Case Rep 2019; 28:100955. [PMID: 31709142 PMCID: PMC6831833 DOI: 10.1016/j.rmcr.2019.100955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 10/07/2019] [Accepted: 10/15/2019] [Indexed: 11/19/2022] Open
Abstract
Corticosteroid therapy may not be enough to control pneumonitis in some cases of severe drug-induced lung injury (DLI); however, an advanced treatment strategy for such cases is lacking. Here, we report the case of an 88-year-old man who presented with severe DLI, caused by Sai-rei-to. The patient visited our hospital complaining of progressive dyspnea. High-resolution computed tomography of the chest demonstrated bilateral patchy ground-glass opacities and infiltrative shadows. Nasal high-flow oxygen therapy was initiated because of severe hypoxemia. Bronchoalveolar lavage on admission revealed diffuse alveolar hemorrhage. Further, as the patient had started taking Sai-rei-to a month earlier, DLI caused by Sai-rei-to was the most likely diagnosis. Therefore, Sai-rei-to was stopped and steroid pulse therapy was initiated. However, he still required high-flow oxygen therapy. We considered an alternative diagnosis of Goodpasture syndrome or anti-neutrophil cytoplasmic antibody (ANCA) related vasculitis. We initiated the administration of cyclosporin A and therapeutic plasma exchange (TPE), but his respiratory condition did not improve satisfactorily. Therefore, we also initiated intravenous immunoglobulin (IVIG) therapy for the treatment of potential vasculitis. Subsequently, his respiratory status began to improve. Further, tests for anti-glomerular basement membrane antibody, myeloperoxidase-ANCA, and proteinase 3-ANCA revealed negative results. Drug-induced lymphocyte stimulation test performed six months after withdrawing methylprednisolone was positive for Sai-rei-to. Thus, the final diagnosis was DLI due to Sai-rei-to. Our findings demonstrate that in cases of severe acute respiratory failure due to DLI, the multi-modal therapy with plasma exchange and IVIG in addition to conventional treatment with prednisolone and immunosuppressant may be beneficial.
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Affiliation(s)
- Midori Yamada
- Department of General Medicine, Awa Regional Medical Center, 1155, Yamamoto, Tateyama-shi, Chiba, 294-0014, Japan
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa-shi, Chiba, 296-8602, Japan
- Department of Family Medicine, Kyoto Min-iren Asukai Hospital, 89 Tanaka Asukai-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8226, Japan
- Corresponding author. Department of General Medicine, Awa Regional Medical Center, 1155, Yamamoto, Tateyama-shi, Chiba, 294-0014, Japan.
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa-shi, Chiba, 296-8602, Japan
| | - Hiroyuki Ito
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa-shi, Chiba, 296-8602, Japan
| | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa-shi, Chiba, 296-8602, Japan
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33
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Morishima R, Nakashima K, Suzuki S, Yamami N, Aoshima M. A diver with immersion pulmonary oedema and prolonged respiratory symptoms. Diving Hyperb Med 2018; 48:259-261. [PMID: 30517959 DOI: 10.28920/dhm48.4.259-261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 11/17/2018] [Indexed: 11/05/2022]
Abstract
Immersion pulmonary oedema (IPE) is particularly associated with an excessive reaction to exercise and/or cold stress. IPE usually resolves without recompression therapy within a day or two. Herein we report a diver diagnosed with IPE, in whom symptoms persisted for five days. A 58-year-old man presented with sudden onset of dyspnoea, cough and haemoptysis after surfacing. He was an experienced diving instructor with a history of moderate mitral valve regurgitation. While IPE was diagnosed and oxygen administered, respiratory symptoms deteriorated, and serum C-reactive protein elevated. No evidence of infection was seen. Three hyperbaric oxygen treatments were given on the basis of suspected decompression sickness, and symptoms subsequently resolved. The recently diagnosed mitral valve regurgitation and inflammatory response were considered to have contributed to the prolongation of symptoms.
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Affiliation(s)
- Ryo Morishima
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan.,Department of Pulmonary Medicine, Kameda Medical Centre, Kamogawa, Chiba, Japan.,Department of Medicine, Awa Regional Medical Centre, Tateyama, Chiba.,Corresponding author: 183-0042 Musashidai 2-6-1, Fuchu city, Tokyo, 183-0042, Japan,
| | - Kei Nakashima
- Department of Pulmonary Medicine, Kameda Medical Centre, Kamogawa, Chiba, Japan
| | - Shinya Suzuki
- Department of Emergency Medicine, Kameda Medical Centre
| | | | - Masahiro Aoshima
- Department of Pulmonary Medicine, Kameda Medical Centre, Kamogawa, Chiba, Japan
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34
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Shiroshita A, Nakashima K, Motojima S, Aoshima M. Refractory diffuse alveolar hemorrhage caused by eosinophilic granulomatosis with polyangiitis in the absence of elevated biomarkers treated successfully by rituximab and mepolizumab: A case report. Respir Med Case Rep 2018; 26:112-114. [PMID: 30603598 PMCID: PMC6302118 DOI: 10.1016/j.rmcr.2018.12.010] [Citation(s) in RCA: 5] [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: 10/24/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 11/18/2022] Open
Abstract
Here we report on a 61-year-old man with refractory eosinophilic granulomatosis with polyangiitis (EGPA) who presented with dyspnea. Despite treatment with glucocorticoids, intravenous cyclophosphamide, and plasma exchange, his symptoms worsened despite his eosinophil count and myeloperoxidase antineutrophil cytoplasmic antibody titer trending downwards. EGPA with diffuse alveolar hemorrhage was diagnosed on analysis of bronchoalveolar lavage fluid. The patient was treated with rituximab and methylprednisolone pulse therapy and a remission was achieved. He has been receiving mepolizumab since then and remains in remission. It should be recognized that refractory diffuse alveolar hemorrhage can occur in patients with EGPA without elevation of biomarkers if they are receiving systemic corticosteroids.
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Affiliation(s)
- Akihiro Shiroshita
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Chiba, Japan
- Corresponding author. Department of Pulmonary Medicine, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Shinji Motojima
- Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Chiba, Japan
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35
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Nemoto M, Misawa M, Nomori H, Tateishi A, Tsuzuki R, Otsuki A, Nakashima K, Oyama Y, Sugimura H, Shoji K, Aoshima M. The efficacy and safety of induction chemoradiotherapy (ICRT) followed by surgery in stage III NSCLC patients (pts) with T3/4-adjacent organ invasion involved(AOI): A single-center retrospective observational study. Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa2223] [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: 11/05/2022]
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36
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Tateishi A, Misawa M, Nomori H, Nemoto M, Tsuzuki R, Otsuki A, Nakashima K, Oyama Y, Sugimura H, Shoji K, Aoshima M. The efficacy of induction chemoradiotherapy followed by surgery in stage IIIA-proven N2 NSCLC and the influence of lymph node downstage on the incidence of postoperative recurrence. Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa2222] [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: 11/05/2022]
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37
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Nemoto M, Noma S, Otsuki A, Nakashima K, Honma K, Johkoh T, Fukuoka J, Aoshima M. Combined pulmonary fibrosis and emphysema with myeloperoxidase-antineutrophil cytoplasmic antibody positivity that resolved upon smoking cessation. Respir Med Case Rep 2018; 25:165-169. [PMID: 30186756 PMCID: PMC6122309 DOI: 10.1016/j.rmcr.2018.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 08/25/2018] [Accepted: 08/25/2018] [Indexed: 11/30/2022] Open
Abstract
Myeloperoxidase antineutrophil cytoplasmic autoantibody (MPO-ANCA) is well-known as a serological marker for small-vessel vasculitis. However, when a smoker with interstitial lung disease (ILD) exhibits serum ANCA positivity without systemic vasculitis, diagnosis is a matter of debate; the relationship between smoking and ANCA is unknown. We report a case of combined pulmonary fibrosis and emphysema (CPFE) with elevated MPO-ANCA. Surgical lung biopsy showed emphysema and fibrotic interstitial pneumonia without vasculitis. The MPO-ANCA level decreased after smoking cessation, and no vasculitis or progression was observed during 3 years of follow-up. This suggested that smoking cessation was related to normalization of MPO-ANCA and corresponding disease activity.
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Affiliation(s)
- Masahiro Nemoto
- Department of Pulmonary Medicine, Kameda Medical Center, Japan
| | - Satoshi Noma
- Department of Pulmonary Medicine, Kameda Medical Center, Japan.,Department of Pulmonary Medicine, Shonan Kamakura General Hospital, Japan
| | - Ayumu Otsuki
- Department of Pulmonary Medicine, Kameda Medical Center, Japan
| | - Kei Nakashima
- Department of Pulmonary Medicine, Kameda Medical Center, Japan
| | - Koichi Honma
- Department of Pathology, Kameda Medical Center, Japan
| | - Takeshi Johkoh
- Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Japan
| | - Junya Fukuoka
- Department of Pathology, Kameda Medical Center, Japan.,Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Japan
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38
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Yamaguchi T, Fujiwara M, Aoshima M, Senoo A, Matsushita Y, Fukamizu H, Tokura Y. Rapid growth of scalp melanoma in a pediatric patient. J Dermatol 2018; 46:e75-e76. [PMID: 30106485 DOI: 10.1111/1346-8138.14589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Tomohiko Yamaguchi
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masao Fujiwara
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Ayumi Senoo
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuki Matsushita
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hidekazu Fukamizu
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Masuda Y, Aoshima M, Shimauchi T, Funakoshi A, Fujiyama T, Ito T, Tokura Y. Acute generalized exanthematous pustulosis caused by fexofenadine. J Cutan Immunol Allergy 2018. [DOI: 10.1002/cia2.12020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Yurika Masuda
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Masahiro Aoshima
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Takatoshi Shimauchi
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Atsuko Funakoshi
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Toshiharu Fujiyama
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Taisuke Ito
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Yoshiki Tokura
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
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Hamaguchi S, Suzuki M, Sasaki K, Abe M, Wakabayashi T, Sando E, Yaegashi M, Morimoto S, Asoh N, Hamashige N, Aoshima M, Ariyoshi K, Morimoto K. Six underlying health conditions strongly influence mortality based on pneumonia severity in an ageing population of Japan: a prospective cohort study. BMC Pulm Med 2018; 18:88. [PMID: 29792181 PMCID: PMC5967104 DOI: 10.1186/s12890-018-0648-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/10/2018] [Indexed: 11/16/2022] Open
Abstract
Background Mortality prediction of pneumonia by severity scores in patients with multiple underlying health conditions has not fully been investigated. This prospective cohort study is to identify mortality-associated underlying health conditions and to analyse their influence on severity-based pneumonia mortality prediction. Methods Adult patients with community-acquired pneumonia or healthcare-associated pneumonia (HCAP) who visited four community hospitals between September 2011 and January 2013 were enrolled. Candidate underlying health conditions, including demographic and clinical characteristics, were incorporated into the logistic regression models, along with CURB (confusion, elevated urea nitrogen, tachypnoea, and hypotension) score as a measure of disease severity. The areas under the receiver operating characteristic curves (AUROC) of the predictive index based on significant underlying health conditions was compared to that of CURB65 (CURB and age ≥ 65) score or Pneumonia severity index (PSI). Mortality association between disease severity and the number of underlying health conditions was analysed. Results In total 1772 patients were eligible for analysis, of which 140 (7.9%) died within 30 days. Six underlying health conditions were independently associated: home care (adjusted odds ratio, 5.84; 95% confidence interval, CI, 2.28–14.99), recent hospitalization (2.21; 1.36–3.60), age ≥ 85 years (2.15; 1.08–4.28), low body mass index (1.99, 1.25–3.16), neoplastic disease (1.82; 1.17–2.85), and male gender (1.78; 1.16–2.75). The predictive index based on these conditions alone had a significantly or marginally higher AUROC than that based on CURB65 score (0.78 vs 0.66, p = 0.02) or PSI (0.78 vs 0.71, p = 0.05), respectively. Compared to this index, the AUROC of the total score consisting of six underlying health conditions and CURB score (range 0–10) did not improve mortality predictions (p = 0.3). In patients with one or less underlying health conditions, the mortality was discretely associated with severe pneumonia (CURB65 ≥ 3) (risk ratio: 7.24, 95%CI: 3.08–25.13), whereas in patients with 2 or more underlying health conditions, the mortality association with severe pneumonia was not detected (risk ratio: 1.53, 95% CI: 0.94–2.50). Conclusions Mortality prediction based on pneumonia severity scores is highly influenced by the accumulating number of underlying health conditions in an ageing society. The validation using a different cohort is necessary to generalise the conclusion. Electronic supplementary material The online version of this article (10.1186/s12890-018-0648-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sugihiro Hamaguchi
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan.,Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Motoi Suzuki
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Kota Sasaki
- Department of Laboratory Medicine, Ebetsu City Hospital, Ebetsu, Japan
| | - Masahiko Abe
- Department of General Internal Medicine, Ebetsu City Hospital, Ebetsu, Japan
| | - Takao Wakabayashi
- Department of General Medicine, Sapporo Hokushin Hospital, Sapporo, Japan
| | - Eiichiro Sando
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.,Department of General Internal Medicine, Kameda Medical Centre, Kamogawa, Japan
| | - Makito Yaegashi
- Department of General Internal Medicine, Kameda Medical Centre, Kamogawa, Japan
| | - Shimpei Morimoto
- Innovation platform & office for precision medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Norichika Asoh
- Department of Internal Medicine, Juzenkai Hospital, Nagasaki, Japan
| | | | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Centre, Kamogawa, Japan
| | - Koya Ariyoshi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Konosuke Morimoto
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
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Suzuki M, Katsurada N, Le MN, Kaneko N, Yaegashi M, Hosokawa N, Otsuka Y, Aoshima M, Yoshida LM, Morimoto K. Effectiveness of inactivated influenza vaccine against laboratory-confirmed influenza pneumonia among adults aged ≥65 years in Japan. Vaccine 2018; 36:2960-2967. [PMID: 29685596 PMCID: PMC7126450 DOI: 10.1016/j.vaccine.2018.04.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/19/2018] [Accepted: 04/16/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND The effectiveness of inactivated influenza vaccine (IIV) against laboratory-confirmed influenza pneumonia in older adults remains to be established. METHODS Pneumonia patients aged ≥65 years who visited a study hospital in Chiba, Japan, were prospectively enrolled from February 2012 to January 2014. Sputum samples were collected from participants and tested for influenza virus by polymerase chain reaction assays. Influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza pneumonia was estimated by a test-negative design. RESULTS Among a total of 814 pneumonia patients, 42 (5.2%) tested positive for influenza: 40 were positive for influenza A virus, and two were positive for influenza B virus. The IVE against laboratory-confirmed influenza pneumonia was 58.3% (95% confidence interval, 28.8-75.6%). The IVE against influenza pneumonia hospital admission, severe pneumonia, and death was 60.2% (95% CI, 22.8-79.4%), 65.5% (95% CI, 44.3-78.7%), and 71% (95% CI, -62.9% to 94.8%), respectively. In the subgroup analyses, the IVE against influenza pneumonia was higher for patients with immunosuppressive conditions (85.9%; 95% CI, 67.4-93.9%) than for those without (48.7%; 95% CI, 2.7-73%) but did not differ by patients' statin use status. CONCLUSION IIV effectively reduces the risk of laboratory-confirmed influenza pneumonia in older adults.
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Affiliation(s)
- Motoi Suzuki
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Adult Pneumonia Study Group-Japan, Japan.
| | - Naoko Katsurada
- Adult Pneumonia Study Group-Japan, Japan; Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan; Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Minh Nhat Le
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Norihiro Kaneko
- Adult Pneumonia Study Group-Japan, Japan; Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan
| | - Makito Yaegashi
- Adult Pneumonia Study Group-Japan, Japan; Department of General Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Naoto Hosokawa
- Adult Pneumonia Study Group-Japan, Japan; Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Japan
| | - Yoshihito Otsuka
- Adult Pneumonia Study Group-Japan, Japan; Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Masahiro Aoshima
- Adult Pneumonia Study Group-Japan, Japan; Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan
| | - Lay Myint Yoshida
- Adult Pneumonia Study Group-Japan, Japan; Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Konosuke Morimoto
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Adult Pneumonia Study Group-Japan, Japan
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Nakashima K, Aoshima M, Ohfuji S, Yamawaki S, Nemoto M, Hasegawa S, Noma S, Misawa M, Hosokawa N, Yaegashi M, Otsuka Y. Immunogenicity of simultaneous versus sequential administration of a 23-valent pneumococcal polysaccharide vaccine and a quadrivalent influenza vaccine in older individuals: A randomized, open-label, non-inferiority trial. Hum Vaccin Immunother 2018; 14:1923-1930. [PMID: 29561248 PMCID: PMC6150043 DOI: 10.1080/21645515.2018.1455476] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
It is unclear whether simultaneous administration of a 23-valent pneumococcal polysaccharide vaccine (PPSV23) and a quadrivalent influenza vaccine (QIV) produces immunogenicity in older individuals. This study tested the hypothesis that the pneumococcal antibody response elicited by simultaneous administration of PPSV23 and QIV in older individuals is not inferior to that elicited by sequential administration of PPSV23 and QIV. We performed a single-center, randomized, open-label, non-inferiority trial comprising 162 adults aged ≥65 years randomly assigned to either the simultaneous (simultaneous injections of PPSV23 and QIV) or sequential (control; PPSV23 injected 2 weeks after QIV vaccination) groups. Pneumococcal immunoglobulin G (IgG) titers of serotypes 23F, 3, 4, 6B, 14, and 19A were assessed. The primary endpoint was the serotype 23F response rate (a ≥2-fold increase in IgG concentrations 4–6 weeks after PPSV23 vaccination). With the non-inferiority margin set at 20% fewer patients, the response rate of serotype 23F in the simultaneous group (77.8%) was not inferior to that of the sequential group (77.6%; difference, 0.1%; 90% confidence interval, −10.8% to 11.1%). None of the pneumococcal IgG serotype titers were significantly different between the groups 4–6 weeks after vaccination. Simultaneous administration did not show a significant decrease in seroprotection odds ratios for H1N1, H3N2, or B/Phuket influenza strains other than B/Texas. Additionally, simultaneous administration did not increase adverse reactions. Hence, simultaneous administration of PPSV23 and QIV shows an acceptable immunogenicity that is comparable to sequential administration without an increase in adverse reactions. (This study was registered with ClinicalTrials.gov [NCT02592486]).
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Affiliation(s)
- Kei Nakashima
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Masahiro Aoshima
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Satoko Ohfuji
- b Department of Public Health , Osaka City University Graduate School of Medicine , Osaka , Japan
| | - Satoshi Yamawaki
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Masahiro Nemoto
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Shinya Hasegawa
- c Department of General Internal Medicine , Kameda Medical Center , Chiba , Japan
| | - Satoshi Noma
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Masafumi Misawa
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Naoto Hosokawa
- d Department of Infectious Disease , Kameda Medical Center , Chiba , Japan
| | - Makito Yaegashi
- c Department of General Internal Medicine , Kameda Medical Center , Chiba , Japan
| | - Yoshihito Otsuka
- e Department of Laboratory Medicine , Kameda Medical Center , Chiba , Japan
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Shiroshita A, Nakashima K, Tanaka Y, Tateishi A, Nemoto M, Aoshima M. Successful treatment with idarucizumab for diffuse alveolar hemorrhage induced by dabigatran etexilate: a case report. J Thromb Thrombolysis 2018; 46:271-273. [PMID: 29740732 DOI: 10.1007/s11239-018-1676-4] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We report the case of an 81-year-old man taking dabigatran etexilate (dabigatran) for chronic atrial fibrillation, who presented with acute-onset hemoptysis and hypoxia. Chest high-resolution computed tomography showed bilateral ground grass opacities. After admission, his respiratory failure progressed rapidly and bronchoalveolar lavage was performed immediately, which showed copious amounts of bloody fluid and hemosiderin-laden macrophages with Prussian blue staining. He was diagnosed as having diffuse alveolar hemorrhage (DAH). We therefore stopped dabigatran and initiated multimodality therapy including idarucizumab, which is a reversal agent for dabigatran. Clinical and radiological improvement was observed and he was discharged without any impairment. There has been no relapse of DAH since then. No abnormalities were detected on further investigation; finally, we concluded that his DAH was caused by dabigatran. This is the first known case of idarucizumab use for severe DAH caused by dabigatran. Our case suggested that dabigatran can cause life-threatening DAH; in such cases, administering idarucizumab could be an effective treatment option.
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Affiliation(s)
- Akihiro Shiroshita
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan
| | - Yu Tanaka
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan
| | - Akiko Tateishi
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan
| | - Masahiro Nemoto
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan
| | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan.
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Nakazawa S, Aoshima M, Funakoshi A, Shimauchi T, Asakawa S, Hirasawa N, Tokura Y. 650 Suprabasin-deficient mice show limited but discernible defective barrier in both skin and upper digestive tract. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Terada A, Aoshima M, Tanizaki H, Nakazawa Y, Ogi T, Tokura Y, Moriwaki S. An adolescent case of xeroderma pigmentosum variant confirmed by the onset of sun exposure-related skin cancer during Crohn's disease treatment. J Cutan Immunol Allergy 2018. [DOI: 10.1002/cia2.12011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Aoi Terada
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
| | - Masahiro Aoshima
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Hideaki Tanizaki
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
| | - Yuka Nakazawa
- Department of Genome Repair; Atomic Bomb Disease Institute; Nagasaki University; Nagasaki Japan
- Department of Genetics; Research Institute of Environmental Medicine; Nagoya University; Nagoya Japan
| | - Tomoo Ogi
- Department of Genetics; Research Institute of Environmental Medicine; Nagoya University; Nagoya Japan
| | - Yoshiki Tokura
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
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Imai K, Petigara T, Kohn MA, Nakashima K, Aoshima M, Shito A, Kanazu S. Risk of pneumococcal diseases in adults with underlying medical conditions: a retrospective, cohort study using two Japanese healthcare databases. BMJ Open 2018; 8:e018553. [PMID: 29500201 PMCID: PMC5855349 DOI: 10.1136/bmjopen-2017-018553] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES To quantify the risk of pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) in adults aged ≥19 years with underlying medical conditions compared with healthy adults of the same age in Japan. DESIGN An observational, retrospective, cohort study using two healthcare claims databases in Japan: Japan Medical Data Center (JMDC) and Medical Data Vision (MDV) databases. PARTICIPANTS A total of 10.4 million individuals, representing 9.3 million person-years of follow-up, were included in the analysis. Eleven medical conditions as well as PP and IPD were identified by the International Statistical Classification of Diseases and Related Health Problems version 10 diagnostic codes and/or local disease codes used in Japan. PRIMARY OUTCOME MEASURES Adjusted rate ratios (RRs) for PP and IPD in adults with a medical condition versus adults without any medical condition were calculated using multivariate Poisson regression models with age and/or sex as covariates. RESULTS In the JMDC and MDV databases, respectively, adults ≥19 years with a medical condition (RRs for PP: 3.3 to 13.4, 1.7 to 5.2; RRs for IPD: 12.6 to 43.3, 4.4 to 7.1), adults with two or more medical conditions (PP: 11.6, 2.8; IPD: 18.7, 5.8) and high-risk adults (PP: 12.9, 1.8; IPD: 29.7, 4.0) were at greater risk of PP and IPD compared with their healthy counterparts. Adults aged 50-64 years with an underlying medical condition (PP rate: 38.6 to 212.1 per 100 000 person-years) had a higher rate of PP than those aged ≥65 years without any condition (PP rate: 13.2 to 93.0 per 100 000 person-years). CONCLUSIONS Adults of all ages with an underlying medical condition are at greater risk of PP and IPD compared with adults without any medical condition. This risk increases with the number of underlying medical conditions. Our results support extending pneumococcal vaccination to younger adults with an underlying medical condition, especially those aged 50-64 years.
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Aoshima M, Suzuki Y, Masuda Y, Yoshinari Y, Hashizume H, Tokura Y. Successful treatment of chronic intractable pain with risperidone in a patient with acquired idiopathic generalized anhidrosis. J Dermatol 2018; 45:e189-e190. [PMID: 29446147 DOI: 10.1111/1346-8138.14230] [Citation(s) in RCA: 5] [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] [Indexed: 11/30/2022]
Affiliation(s)
- Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuno Suzuki
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yurika Masuda
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Hideo Hashizume
- Department of Dermatology, Shimada Municipal Hospital, Shimada, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Masuda Y, Tatsuno K, Kitano S, Miyazawa H, Ishibe J, Aoshima M, Shimauchi T, Fujiyama T, Ito T, Tokura Y. Mogamulizumab-induced photosensitivity in patients with mycosis fungoides and other T-cell neoplasms. J Eur Acad Dermatol Venereol 2018; 32:1456-1460. [PMID: 29341283 DOI: 10.1111/jdv.14797] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/03/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mogamulizumab (Mog) is a defucosylated, therapeutic monoclonal antibody, targeting CCR4 and was first approved in Japan for the treatment of adult T-cell leukaemia/lymphoma (ATLL), followed by cutaneous T-cell lymphoma and peripheral T-cell lymphoma. OBJECTIVE To retrospectively investigate development of photosensitivity in patients with mycosis fungoides and other T-cell neoplasms after treatment with Mog. METHODS We treated seven cutaneous lymphoma patients with Mog. Upon combination treatment with narrow-band UVB, we noticed that four patients developed photosensitivity dermatitis following Mog therapy, including two cases of mycosis fungoides, one case of adult T-cell leukaemia/lymphoma and one case of EB virus-associated T-cell lymphoproliferative disorder. Phototest was performed with UVA and UVB, and immunohistochemical staining for CD4, CD8 and Foxp3 was conducted in both photosensitivity and lymphoma lesions. RESULTS Phototest revealed that the action spectrum of the photosensitivity was UVB in three cases and both UVB and UVA in one case. Histopathologically, the photosensitive lesions were characterized by a lichenoid tissue reaction with a CD8+ T cell-dominant infiltrate, sharing the feature with chronic actinic dermatitis, an autoreactive photodermatosis with a cytotoxic T-cell response. Foxp3+ regulatory T cells (Tregs) were decreased in the photosensitivity lesions compared with the lymphoma lesions. CONCLUSION Increased incidence of photosensitivity reaction was observed during Mog treatment. Decreased number of Tregs in the lesional skin suggests that this reaction is possibly induced by autoreactive cytotoxic T cells.
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Affiliation(s)
- Y Masuda
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - K Tatsuno
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - S Kitano
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - H Miyazawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - J Ishibe
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - M Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Fujiyama
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Ito
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Y Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Katsurada N, Suzuki M, Aoshima M, Yaegashi M, Ishifuji T, Asoh N, Hamashige N, Abe M, Ariyoshi K, Morimoto K. The impact of virus infections on pneumonia mortality is complex in adults: a prospective multicentre observational study. BMC Infect Dis 2017; 17:755. [PMID: 29212450 PMCID: PMC5719746 DOI: 10.1186/s12879-017-2858-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 11/26/2017] [Indexed: 11/29/2022] Open
Abstract
Background Various viruses are known to be associated with pneumonia. However, the impact of viral infections on adult pneumonia mortality remains unclear. This study aimed to clarify the effect of virus infection on pneumonia mortality among adults stratified by virus type and patient comorbidities. Methods This multicentre prospective study enrolled pneumonia patients aged ≥15 years from September 2011 to August 2014. Sputum samples were tested by in-house multiplex polymerase chain reaction assays to identify 13 respiratory viruses. Viral infection status and its effect on in-hospital mortality were examined by age group and comorbidity status. Results A total of 2617 patients were enrolled in the study and 77.8% was aged ≥65 years. 574 (21.9%) did not have comorbidities, 790 (30.2%) had chronic respiratory disease, and 1253 (47.9%) had other comorbidities. Viruses were detected in 605 (23.1%) patients. Human rhinovirus (9.8%) was the most frequently identified virus, followed by influenza A (3.9%) and respiratory syncytial virus (3.9%). Respiratory syncytial virus was more frequently identified in patients with chronic respiratory disease (4.7%) than those with other comorbidities (4.2%) and without comorbidities (2.1%) (p = 0.037). The frequencies of other viruses were almost identical between the three groups. Virus detection overall was not associated with increased mortality (adjusted risk ratio (ARR) 0.76, 95% CI 0.53–1.09). However, influenza virus A and B were associated with three-fold higher mortality in patients with chronic respiratory disease but not with other comorbidities (ARR 3.38, 95% CI 1.54–7.42). Intriguingly, paramyxoviruses were associated with dramatically lower mortality in patients with other comorbidities (ARR 0.10, 95% CI 0.01–0.70) but not with chronic respiratory disease. These effects were not affected by age group. Conclusions The impact of virus infections on pneumonia mortality varies by virus type and comorbidity status in adults. Electronic supplementary material The online version of this article (10.1186/s12879-017-2858-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Naoko Katsurada
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan.,Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Japan
| | - Motoi Suzuki
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | - Masahiro Aoshima
- Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Makito Yaegashi
- Department of General Internal Medicine, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Tomoko Ishifuji
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Norichika Asoh
- Department of Internal Medicine, Juzenkai Hospital, 7-18 Kagomachi, Nagasaki, Japan
| | - Naohisa Hamashige
- Department of Internal Medicine, Chikamori Hospital, 1-1-16 Okawasuji, Kochi, Japan
| | - Masahiko Abe
- Department of General Internal Medicine, Ebetsu City Hospital, 6 Wakakusacho, Ebetsu, Hokkaido, Japan
| | - Koya Ariyoshi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Konosuke Morimoto
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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Yatagai T, Shimauchi T, Yamaguchi H, Sakabe JI, Aoshima M, Ikeya S, Tatsuno K, Fujiyama T, Ito T, Ojima T, Tokura Y. Sensitive skin is highly frequent in extrinsic atopic dermatitis and correlates with disease severity markers but not necessarily with skin barrier impairment. J Dermatol Sci 2017; 89:33-39. [PMID: 29122406 DOI: 10.1016/j.jdermsci.2017.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 02/08/2017] [Revised: 10/19/2017] [Accepted: 10/25/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Sensitive skin is a condition of cutaneous hypersensitivity to environmental factors. Lactic acid stinging test (LAST) is commonly used to assess sensitive skin and composed of four distinct sensations (pain, burning sensation, itch, and crawly feeling). A link between sensitive skin and barrier dysfunction has been proposed in atopic dermatitis (AD) patients. However, clinical and laboratory factors that are associated with sensitive skin remain unelucidated. OBJECTIVE To investigate relationship between sensitive skin and AD-associated markers. METHODS Forty-two Japanese AD patients and 10 healthy subjects (HS) were enrolled. AD patients were divided into extrinsic (EAD; high IgE levels) and intrinsic (IAD; normal IgE levels) types. We conducted 1% LAST by assessing the four distinct sensations and calculated the frequencies of sensitive skin in EAD, IAD, and HS. We also performed clinical AD-related tests, including transepidermal water loss (TEWL), visual analogue scale (VAS) of pruritus, and quality of life, and measured laboratory markers, including blood levels of IgE, CCL17/TARC, lactate dehydrogenase (LDH) and eosinophil counts, and concentration levels of serum Th1/Th2 cytokines. Filaggrin (FLG) mutations were examined in 21 patients. These values were subjected to correlation analyses with each of the four sensation elements. RESULTS According to the standard criteria for LAST positivity, the frequencies of LAST-positive subjects were 54.8% and 10.0% in AD and HS, respectively (P=0.014). EAD patients showed a significantly (P=0.026) higher frequency of positive LAST (65.6%) than did IAD patients (20.0%). Among the four LAST sensation elements, the crawly feeling and pain scores positively correlated with VAS of pruritus, total serum IgE, mite-specific IgE, CCL17/TARC, and/or LDH. There was no association of the LAST scores with serum Th1/Th2 cytokine levels. Notably, neither TEWL nor FLG mutations correlated with LAST positivity or any sensation scores. CONCLUSIONS The frequency of sensitive skin is higher in EAD than in IAD. Sensitive skin is associated with AD severity, but not necessarily with barrier condition.
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Affiliation(s)
- Tsuyoshi Yatagai
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | - Takatoshi Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hayato Yamaguchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan; Department of Dermatology, Self-Defense Forces Central Hospital, Tokyo, Japan
| | - Jun-Ichi Sakabe
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan; Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Masahiro Aoshima
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shigeki Ikeya
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazuki Tatsuno
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Toshiharu Fujiyama
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taisuke Ito
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Toshiyuki Ojima
- Department of Community of Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
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