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Osawa T, Watanabe M, Morimoto K, Yoshiyama T, Matsuda S, Fujiwara K, Furuuchi K, Shimoda M, Ito M, Kodama T, Uesugi F, Okumura M, Tanaka Y, Sasaki Y, Ogata H, Goto H, Kudoh S, Ohta K. Activities of Daily Living, Hypoxemia, and Lymphocytes Score for Predicting Mortality Risk in Patients With Pulmonary TB. Chest 2024; 165:267-277. [PMID: 37726072 DOI: 10.1016/j.chest.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND A clinically applicable mortality risk prediction system for pulmonary TB may improve treatment outcomes, but no easy-to-calculate and accurate score has yet been reported. The aim of this study was to construct a simple and objective disease severity score for patients with pulmonary TB. RESEARCH QUESTION Does a clinical score consisting of simple objective factors predict the mortality risk of patients with pulmonary TB? STUDY DESIGN AND METHODS The data set from our previous prospective study that recruited patients newly diagnosed with pulmonary TB was used for the development cohort. Patients for the validation cohort were prospectively recruited between March 2021 and September 2022. The primary end point was all-cause in-hospital mortality. Using Cox proportional hazards regression, a mortality risk prediction model was optimized in the development cohort. The disease severity score was developed by assigning integral points to each variate. RESULTS The data from 252 patients in the development cohort and 165 patients in the validation cohort were analyzed, of whom 39 (15.5%) and 17 (10.3%), respectively, died in the hospital. The disease severity score (named the AHL score) included three clinical parameters: activities of daily living (semi-dependent, 1 point; totally dependent, 2 points); hypoxemia (1 point), and lymphocytes (< 720/μL, 1 point). This score showed good discrimination with a C statistic of 0.902 in the development cohort and 0.842 in the validation cohort. We stratified the score into three groups (scores of 0, 1-2, and 3-4), which clearly corresponded to low (0% and 1.3%), intermediate (13.5% and 8.9%), and high (55.8% and 39.3%) mortality risk in the development and validation cohorts. INTERPRETATION The easy-to-calculate AHL disease severity score for patients with pulmonary TB was able to categorize patients into three mortality risk groups with great accuracy. CLINICAL TRIAL REGISTRATION University Hospital Medical Information Network Center; No. UMIN000012727 and No. UMIN000043849; URL: www.umin.ac.jp.
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Affiliation(s)
- Takeshi Osawa
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Masato Watanabe
- Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
| | - Kozo Morimoto
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan; Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Takashi Yoshiyama
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan; Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Shuichi Matsuda
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Keiji Fujiwara
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Koji Furuuchi
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Masafumi Shimoda
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Masashi Ito
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Tatsuya Kodama
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Fumiko Uesugi
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Masao Okumura
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Yoshiaki Tanaka
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Yuka Sasaki
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Hideo Ogata
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Hajime Goto
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Shoji Kudoh
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Ken Ohta
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
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Shimoda M, Yoshiyama T, Tanaka Y, Morimoto K, Okumura M, Kodama T, Yoshimori K, Ohta K. Characteristics of pleural effusion due to paradoxical response in patients with pulmonary tuberculosis. J Infect Chemother 2023; 29:890-894. [PMID: 37244351 DOI: 10.1016/j.jiac.2023.05.019] [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: 03/01/2023] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Patients with pulmonary tuberculosis may present with deterioration of pleural effusion during anti-tuberculosis therapy, referred to as a paradoxical response (PR), with some patients requiring additional intervention. However, PR may be confused with other differential diagnoses, and the predictive factors for recommending additional therapies are unknown. Therefore, this study aimed to reveal useful information for the diagnosis and intervention of PR. METHODS Data from human immunodeficiency virus-negative patients with tuberculous pleurisy (n = 210), including 184 patients with pre-existing pleural effusion and 26 patients with PR at Fukujuji Hospital, were retrospectively collected from January 2012 to December 2022 and compared. Furthermore, patients with PR were divided into the intervention group (n = 9) and the no intervention group (n = 17) and were compared. RESULTS Patients in the PR group had lower pleural lactate dehydrogenase (LDH) (median 177 IU/L vs. 383 IU/L, p < 0.001) and higher pleural glucose (median 122 mg/dL vs. 93 mg/dL, p < 0.001) levels than those in the preexisting pleural effusion group. Other pleural fluid data were not significantly different. Patients in the intervention group had a shorter duration from the initiation of anti-tuberculosis therapy to the development of PR than patients in the no intervention group (median 19.0 days [interquartile range (IQR): 18.0-22.0] vs. median 37.0 days [IQR: 28.0-58.0], p = 0.012). CONCLUSION This study demonstrates that, apart from lower pleural LDH and elevated pleural glucose levels, PR presents with similar features to preexisting pleural effusion and that patients who develop PR faster tend to require intervention.
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Affiliation(s)
- Masafumi Shimoda
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose, Tokyo, Japan.
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose, Tokyo, Japan
| | - Masao Okumura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose, Tokyo, Japan
| | - Tatsuya Kodama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose, Tokyo, Japan
| | - Kozo Yoshimori
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose, Tokyo, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose, Tokyo, Japan
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Nishimura M, Okumura M, Takemasa T, Yoshiyama T, Tanaka Y, Saotome M, Ohta K. A case of disseminated M. bovis bacillus Calmette-Guérin (BCG) disease after one month of BCG bladder infusion therapy and analysis of 77 cases of suspected BCG infection in Japan, 2017-2022. Respir Med Case Rep 2023; 45:101902. [PMID: 37538979 PMCID: PMC10393993 DOI: 10.1016/j.rmcr.2023.101902] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/31/2023] [Accepted: 07/22/2023] [Indexed: 08/05/2023] Open
Abstract
Bacillus Calmette-Guerin (BCG) intravesical injections are used as adjuvant therapy for superficial bladder cancer. We report a case of a 78-year-old man who developed disseminated M. bovis BCG disease mimicking miliary tuberculosis early after BCG intravesical infusion. He started coughing after receiving three rounds of BCG for superficial bladder tumors, following transurethral resection of the tumors, approximately one month after initiation. Computerized tomography (CT) images showed diffuse nodular shadows in the bilateral lung fields with a random pattern. Consequently, disseminated BCG disease was diagnosed. Treatment with isoniazid, rifampicin, and ethambutol was initiated. Nine months after initiating treatment, CT showed the disappearance of the miliary shadows. We also discussed 77 cases of suspected BCG infection and the requests for Mycobacterium bovis BCG identification at our institution from 2017 to October 2022. Of these, 76 cases were M. bovis BCG, and 1 case was M. tuberculosis. Since M. tuberculosis can be identified in some patients with suspected BCG infection, it is crucial to distinguish between the two based on pathogenicity.
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Affiliation(s)
- Masashi Nishimura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Masao Okumura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Takii Takemasa
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, Japan
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Mikio Saotome
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
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Shimoda M, Yoshiyama T, Tanaka Y, Morimoto K, Okumura M, Kodama T, Nakajima K, Yoshimori K, Ohta K. Relationship between the thickness of erector spinae muscles and mortality in patients with pulmonary tuberculosis. Respir Investig 2023; 61:511-519. [PMID: 37267852 DOI: 10.1016/j.resinv.2023.04.011] [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: 12/15/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Skeletal muscle mass is a known predictor of mortality in older patients. However, its relationship with tuberculosis is unclear. Skeletal muscle mass is determined by the cross-sectional area of erector spinae muscle (ESMCSA). Additionally, the erector spinae muscle thickness (ESMT) is an easier measurement than ESMCSA. This study investigated the relationship of ESMT and ESMCSA with mortality in tuberculosis patients. METHODS We retrospectively collected the data of 267 older patients (age ≥65 years) who were hospitalized due to tuberculosis at the Fukujuji Hospital from January 2019 to July 2021. This included 40 patients with 60-day mortality (the death group) and 227 patients with 60-day survival (the alive group). Here, we assessed the correlations between ESMCSA and ESMT, and the data were compared between the two groups. RESULTS ESMT had a strong proportional relationship with ESMCSA (r = 0.991, p < 0.001). ESMCSA (median 670.2 mm2 [interquartile range (IQR): 585.1-760.9] vs. 914.3 mm2 [717.6-1141.6], p < 0.001) and ESMT (median 16.7 mm [15.4-18.6] vs. 21.1 mm [18.0-25.5], p < 0.001) were significantly lower in the patients in the death group than those of patients in the alive group. A multivariable Cox proportional hazard model for 60-day mortality showed significantly independent differences in ESMT (hazard ratio [HR] 0.870 [95% confidence interval (Cl): 0.795-0.952], p = 0.003) and ESMCSA (HR 0.998 [95% Cl: 0.996-0.999], p = 0.009). CONCLUSIONS This study demonstrated a strong correlation between ESMCSA and ESMT, which were risk factors for mortality in patients with tuberculosis. Therefore, using ESMT is easier to predict mortality than ESMCSA.
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Affiliation(s)
- Masafumi Shimoda
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan.
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Masao Okumura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Tatsuya Kodama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Kei Nakajima
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Kozo Yoshimori
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
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Imafuku K, Iwata H, Natsuga K, Okumura M, Kobayashi Y, Kitahata H, Kubo A, Nagayama M, Ujiie H. 197 Tissue proliferation and turnover spatially regulates tight junctions in squamous epithelia. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.208] [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: 11/19/2022]
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Taki T, Mori S, Murakami Y, Urata T, Okumura M, Akanabe H, Ebata A, Imai S, Yokota K, Akiyama M. 494 Low plasma fibrinogen levels are associated with poor prognosis in cutaneous angiosarcoma of the head and neck. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.508] [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: 11/19/2022]
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Shimoda M, Yoshiyama T, Okumura M, Tanaka Y, Morimoto K, Kokutou H, Osawa T, Furuuchi K, Fujiwara K, Ito K, Yoshimori K, Ohta K. Analysis of risk factors for pulmonary tuberculosis with persistent severe inflammation: An observational study. Medicine (Baltimore) 2022; 101:e29297. [PMID: 35583541 PMCID: PMC9276154 DOI: 10.1097/md.0000000000029297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 04/27/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Patients with pulmonary tuberculosis (TB) sometimes show persistent severe inflammation for more than 1 month, even if TB treatment is effective. Although this inflammation can be improved through continuous antituberculous therapy, the risk factors for persistent inflammation remain unclear. Therefore, we sought to study the characteristics of patients with persistent severe inflammation. MATERIALS AND METHODS We retrospectively analyzed 147 hospitalized adult patients with C-reactive protein (CRP) levels of 5 mg/dL or more on admission to Fukujuji Hospital from April 2019 to March 2021. The patients were divided into 2 groups: 40 patients (27.2%) had CRP levels of 5 mg/dL or more at 4 weeks after admission (persistent inflammation group), and 107 patients (72.8%) had CRP levels that fell below 5 mg/dL within 4 weeks of admission (improved inflammation group). RESULTS The median CRP level on admission in the persistent inflammation group was 10.8 mg/dL (interquartile range 9.1-14.5), which was higher than that in the improved inflammation group (median 8.2 mg/dL [6.5-12.1], P = .002). Patients in the persistent inflammation group had a higher prevalence of large cavities, defined as cavities ≥4 cm in diameter, on chest computed tomography (CT) (n = 20 [50.0%] vs n = 12 [11.2%], P < .001). DISCUSSION AND CONCLUSIONS This study showed that 27.2% of patients who had high or moderate inflammation on admission did not achieve low CRP levels within 4 weeks after admission. Risk factors for persistent severe inflammation in patients with TB were presence of a large cavity (cavity diameter ≥4 cm) on chest CT and a high CRP level on admission. Therefore, in a patient with a large cavity on chest CT and/or CRP ≥9.0 mg/dL on admission, long-term inflammation may occur despite antituberculous therapy if other diseases are ruled out.
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Shimoda M, Yoshiyama T, Okumura M, Tanaka Y, Morimoto K, Yano R, Arakawa K, Furuuchi K, Fujiwara K, Yoshimori K, Ohta K. Usefulness of gastric aspirate for the diagnosis of smear-negative pulmonary tuberculosis. J Infect Chemother 2022; 28:1041-1044. [PMID: 35450783 DOI: 10.1016/j.jiac.2022.04.013] [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: 10/06/2021] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Gastric aspirate can be useful for the diagnosis of pulmonary tuberculosis (TB) in patients with smear-negative pulmonary TB or without sputum production. The gastric aspirate smear technique has low sensitivity, and a previous report demonstrated that no patient was diagnosed by only gastric aspirate analysis. However, some patients with TB have been negative on sputum examination but positive on gastric aspirate examination, and the incidence of such cases is uncertain. Therefore, this study investigated the usefulness of gastric aspirate in the diagnosis of pulmonary TB. METHODS To analyze the diagnostic accuracy of gastric aspirate examination, the data of 513 patients with negative sputum smears or a lack of sputum production, including 203 patients with pulmonary TB (39.6%) and 93 patients with nontuberculous mycobacteriosis who underwent gastric aspiration at Fukujuji Hospital from January 2016 to March 2021, were collected retrospectively. RESULTS The accuracy rates of gastric aspirate examination for the diagnosis of pulmonary TB were as follows: 21.2% sensitivity and 91.9% specificity for smear positivity, 55.8% sensitivity and 99.6% specificity for nucleic acid amplification test positivity, and 71.4% sensitivity and 100% specificity for culture positivity. Twenty-three patients (11.2%) were diagnosed by gastric aspirate examination alone. Among the 356 patients who underwent three repeated sputum examinations in addition to gastric aspirate examination, the cumulative diagnostic rate for the 3 mycobacterial examinations plus gastric aspirate examination was higher than that for only three sputum examinations. CONCLUSIONS Gastric aspirate is useful for the diagnosis of TB in patients with smear-negative pulmonary TB or without sputum production.
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Affiliation(s)
- Masafumi Shimoda
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan.
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Masao Okumura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Ryozo Yano
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Kenichi Arakawa
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Koji Furuuchi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Keiji Fujiwara
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Kozo Yoshimori
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
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Hoshi K, Hosoya K, Takagi S, Kim S, Okumura M. Direct renal pelvicocystostomy using tube cystoplasty in a cat with ureteral obstruction. J Small Anim Pract 2022; 63:635-641. [DOI: 10.1111/jsap.13479] [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] [Received: 02/03/2020] [Revised: 11/14/2021] [Accepted: 12/29/2021] [Indexed: 11/27/2022]
Affiliation(s)
- K. Hoshi
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine Hokkaido University, Kita 19 Nishi 11, Kita‐ku Sapporo Hokkaido 060‐0819 Japan
| | - K. Hosoya
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine Hokkaido University, Kita 19 Nishi 11, Kita‐ku Sapporo Hokkaido 060‐0819 Japan
- Laboratory of Veterinary Advanced Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine Hokkaido University, Kita 19 Nishi 11, Kita‐ku Sapporo Hokkaido 060‐0819 Japan
| | - S. Takagi
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine Hokkaido University, Kita 19 Nishi 11, Kita‐ku Sapporo Hokkaido 060‐0819 Japan
- Laboratory of Veterinary Advanced Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine Hokkaido University, Kita 19 Nishi 11, Kita‐ku Sapporo Hokkaido 060‐0819 Japan
| | - S. Kim
- Laboratory of Veterinary Surgery, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine Hokkaido University, Kita 19 Nishi 11, Kita‐ku Sapporo Hokkaido 060‐0819 Japan
| | - M. Okumura
- Laboratory of Veterinary Surgery, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine Hokkaido University, Kita 19 Nishi 11, Kita‐ku Sapporo Hokkaido 060‐0819 Japan
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Shimoda M, Takao S, Kokutou H, Yoshida N, Fujiwara K, Furuuchi K, Osawa T, Nakamoto K, Tanaka Y, Morimoto K, Yano R, Okumura M, Uchiyama T, Yoshimori K, Ohta K, Senjyu H. In-hospital pulmonary rehabilitation after completion of primary respiratory disease treatment improves physical activity and ADL performance: A prospective intervention study. Medicine (Baltimore) 2021; 100:e28151. [PMID: 34889282 PMCID: PMC8663887 DOI: 10.1097/md.0000000000028151] [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] [Received: 05/21/2021] [Accepted: 11/18/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Pulmonary rehabilitation improves the physical condition of patients with chronic respiratory disease; however, there are patients who cannot leave the hospital because of their low activities of daily living (ADLs), despite the completion of primary respiratory disease treatment and rehabilitation during treatment. Therefore, this study demonstrated that those patients recovered their ADLs through in-hospital pulmonary rehabilitation after treatment completion. METHODS We prospectively studied 24 hospitalized patients who had some remaining symptoms and showed low ADL scores of 9 points or less on the short physical performance battery after undergoing treatment for respiratory disease in Fukujuji Hospital from October 2018 to October 2019, excluding 2 patients who had re-exacerbation and 1 patient who could not be examined using the incremental shuttle walk test (ISWT). After completion of the primary respiratory disease treatment, patients moved to the regional comprehensive care ward, and they received pulmonary rehabilitation for 2 weeks. In the ward, patients who could not yet leave the hospital could undergo pulmonary rehabilitation for up to 60 days. Data were evaluated three times: upon treatment completion (baseline), postrehabilitation, and 3 months after baseline. The main outcome was an improvement in the incremental shuttle walk test (ISWT) postrehabilitation. RESULTS The median age of the patients was 80 (interquartile range (IQR): 74.8-84.5), and 14 patients (58.3%) were male. The ISWT distance significantly increased postrehabilitation (median [IQR]: 60 m [18-133] vs 120 m [68-203], P < .001). The Barthel Index (BI) (P < .001), the modified Medical Research Council (P < .001), and other scale scores were also improved. Among patients with acute respiratory diseases such as pneumonia, chronic obstructive pulmonary disease, and interstitial pneumonia, ISWT and other data showed improvement at the postrehabilitation timepoint. Ten patients who could perform examinations at 3 months after baseline were evaluated 3 months after taking baseline data prior to starting rehabilitation. The ISWT showed significant improvement 3 months after baseline compared to baseline (P = .024), and the ISWT distance was maintained after rehabilitation. DISCUSSION AND CONCLUSIONS Physical activity, symptoms, mental health, and ADL status in patients who had not recovered after primary treatment completion for respiratory diseases could improve through in-hospital pulmonary rehabilitation.
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Affiliation(s)
- Masafumi Shimoda
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Satoshi Takao
- Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Hiroyuki Kokutou
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Naoyuki Yoshida
- Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Keiji Fujiwara
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Koji Furuuchi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Takeshi Osawa
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Keitaro Nakamoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Ryozo Yano
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Masao Okumura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Takashi Uchiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Kozo Yoshimori
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
| | - Hideaki Senjyu
- Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan
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11
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Ebata A, Taki T, Mori S, Murakami Y, Okumura M, Akanabe H, Imai S, Yokota K, Akiyama M. 283 Neutrophil/lymphocyte ratio as a predictor of lymph node metastasis in extramammary Paget disease: A retrospective study. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Takase Y, Kawamura M, Nakahara R, Itoh J, Oie Y, Okumura M, Kamomae T, Itoh Y, Ono T, Naganawa S. PO-1036 Malignant. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07487-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Okumura M, Du J, Kageyama S, Yamashita R, Motegi A, Hojo H, Nakamura M, Hirano Y, Okuma Y, Okuma H, Tsuchihara K, Tetsuo A. PH-0436 Comprehensive screening for drugs that modify radiation-induced immune responses. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07327-8] [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: 11/28/2022]
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14
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Kawamura M, Nakahara R, Ishihara S, Oie Y, Takase Y, Okumura M, Ito J, Ono T, Itoh Y, Naganawa S. PO-1291 Can we safely lower the RT dose with the use of high dose PF for advanced cervical cancer? Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07742-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Okumura M, Tachibana D, Fudaba M, Misugi T, Koyama M. Fused yolk sacs in a case of forked umbilical cord in monochorionic diamniotic twin pregnancy: sonoembryological implications. Ultrasound Obstet Gynecol 2021; 58:142-143. [PMID: 32621308 DOI: 10.1002/uog.22142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/20/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Affiliation(s)
- M Okumura
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - D Tachibana
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Fudaba
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Misugi
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Koyama
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
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16
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Shimoda M, Tanaka Y, Morimoto K, Okumura M, Shimoda K, Takemura T, Oka T, Yoshiyama T, Yoshimori K, Ohta K. IgG4-related pleural effusion with high adenosine deaminase levels: A case report and literature review. Medicine (Baltimore) 2021; 100:e25162. [PMID: 33726002 PMCID: PMC7982235 DOI: 10.1097/md.0000000000025162] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Levels of pleural fluid adenosine deaminase (ADA), a useful marker for the diagnosis of tuberculous pleurisy, are elevated in some reports of immunoglobulin G4 (IgG4)-related pleural effusion. We describe a patient with IgG4-related pleural effusion who exhibited a high concentration of ADA. Furthermore, we reviewed the literature to compare patients with IgG4-related pleural effusion and tuberculous pleurisy. PATIENT CONCERNS A 75-year-old male patient had dyspnea for 1 month with a left pleural effusion that was exudative, lymphocyte dominant. The pleural fluid test results revealed a total protein (TP) concentration of 6.60 g/dl, a lactate dehydrogenase (LDH) level of 383 IU/dl, and an ADA concentration of 54.5 U/L. An interferon gamma release assay showed a negative result. DIAGNOSES Histological analysis of the thoracoscopic pleural biopsy revealed lymphoplasmacytic infiltration, with 80 IgG4-positive plasma cells/high-power field, and an IgG4/IgG ratio of approximately 40% to 50%. Other diseases were ruled out based on symptoms, negative autoimmune antigen results, and histopathologic findings. Thus, he was diagnosed with IgG4-related pleural effusion. INTERVENTIONS He received 15 mg of prednisolone as therapy. OUTCOMES His pleural effusion and symptoms improved gradually within several months, and prednisolone was tapered to 6 mg daily. LESSONS It is important to distinguish between IgG4-related pleural effusion and tuberculous pleurisy. Therefore, we compared 22 patients with IgG4-related pleural effusion from PubMed and the Japan Medical Abstracts Society to 40 patients with tuberculous pleurisy at Fukujuji Hospital from January 2017 to May 2019. According to thoracentesis findings, 14 of 18 patients with IgG4-related pleural effusion had high ADA more than 40 U/L. The pleural effusion of patients with IgG4-related pleural effusion showed higher TP levels (P < .001) and lower LDH (P < .001) and ADA levels (P = .002) than those with tuberculous pleurisy. Moreover, the pleural fluid ADA/TP ratio was a good predictor for differentiating IgG4-related pleural effusion and tuberculous pleurisy (area under the receiver operating characteristic curve of 0.909; 95% confidence level: 0.824-0.994).
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Affiliation(s)
| | | | | | | | - Kiyomi Shimoda
- Department of Thoracic Surgery, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo
| | - Tamiko Takemura
- Kanagawa Cardiovascular and Respiratory Center, Department of Pathology, Tomioka-higashi, Kanazawa-ku, Yokohama, Kanagawa
| | - Teruaki Oka
- Department of Pathology, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
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17
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Osawa T, Watanabe M, Morimoto K, Okumura M, Yoshiyama T, Ogata H, Goto H, Kudoh S, Ohta K, Sasaki Y. Serum Procalcitonin Levels Predict Mortality Risk in Patients With Pulmonary Tuberculosis: A Single-Center Prospective Observational Study. J Infect Dis 2021; 222:1651-1654. [PMID: 32445568 DOI: 10.1093/infdis/jiaa275] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/18/2020] [Indexed: 11/14/2022] Open
Abstract
Globally, tuberculosis is the leading infectious cause of death; discovering biomarkers that predict a high mortality risk may improve treatment outcomes. We prospectively enrolled 252 pulmonary tuberculosis patients who were not coinfected with human immunodeficiency virus and initiated antituberculosis treatment, measured serum procalcitonin levels (PCT), and assessed mortality risk. PCT serum levels higher than 0.13 (day 0), 0.05 (day 7), 0.12 (day 14), or 0.06 (day 28) ng/mL predicted nonsurvivors with odds ratios of 7.9, 14.3, 20.0, and 7.3, respectively (P ≤ .005 for all), respectively. Therefore, serum PCT levels are a promising mortality risk indicator for patients with pulmonary tuberculosis. Main Point. For patients with pulmonary tuberculosis, a promising mortality risk indicator is the level of serum procalcitonin, which is weakly associated with sputum bacterial load and independent of radiographic findings.
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Affiliation(s)
- Takeshi Osawa
- Department of Respiratory Medicine, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan
| | - Masato Watanabe
- Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Kozo Morimoto
- Department of Respiratory Medicine, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan.,Division of Clinical Research, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan
| | - Masao Okumura
- Department of Respiratory Medicine, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan
| | - Takashi Yoshiyama
- Department of Respiratory Medicine, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan.,Research institute of tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Hideo Ogata
- Department of Respiratory Medicine, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan
| | - Hajime Goto
- Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Shoji Kudoh
- Department of Respiratory Medicine, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan
| | - Ken Ohta
- Department of Respiratory Medicine, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan
| | - Yuka Sasaki
- Department of Respiratory Medicine, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan
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18
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Miyagawa K, Yamanaka S, Isobe H, Shoji M, Kawakami T, Taniguchi M, Okumura M, Yamaguchi K. Electronic and spin structures of CaMn 4O x clusters in the S 0 state of the oxygen evolving complex of photosystem II. Domain-based local pair natural orbital (DLPNO) coupled-cluster (CC) calculations using optimized geometries and natural orbitals (UNO) by hybrid density functional theory (HDFT) calculations. Phys Chem Chem Phys 2021; 22:27191-27205. [PMID: 33226053 DOI: 10.1039/d0cp04762g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Domain-based local pair natural orbital (DLPNO) coupled cluster single and double (CCSD) with triple perturbation (T) correction methods were performed to elucidate the relative stabilities of ten different intermediate structures of the CaMn4Ox cluster in the S0 state of the oxygen evolving complex (OEC) of photosystem II (PSII). Full geometry optimizations of all the S0 intermediates were performed by the UB3LYP-D3/Def2-TZVP methods, providing the assumed geometrical structures and starting natural orbitals (UNO) for DLPNO-CCSD(T)/Def2TZVP calculations. The effective exchange integrals (J) for the spin Hamiltonian models for the ten intermediates were obtained by the UB3LYP/Def2-TZVP calculations followed by the general spin projections. DLPNO-CCSD(T) calculations followed by the CBS extrapolation procedure elucidated that the (II, III, IV, IV) and (III, III, III, IV) valence states in the CaMn4O5 cluster of the OEC of the PS II were nearly degenerated in energy in the S0 state, indicating an important role of dynamical electron correlation effects for the valence and spin fluctuations in strongly correlated electron systems (SCESs) consisting of 3d transition metals.
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Affiliation(s)
- K Miyagawa
- Institute for Scientific and Industrial Research, Osaka University, Ibaraki, Osaka 567-0047, Japan.
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19
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Miyagawa K, Kawakami T, Suzuki Y, Isobe H, Shoji M, Yamanaka S, Okumura M, Nakajima T, Yamaguchi K. Relative stability among intermediate structures in S2 state of CaMn4O5 cluster in PSII by using hybrid-DFT and DLPNO-CC methods and evaluation of magnetic interactions between Mn ions. J Photochem Photobiol A Chem 2021. [DOI: 10.1016/j.jphotochem.2020.112923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Durif O, Capron M, Messinger JP, Benidar A, Biennier L, Bourgalais J, Canosa A, Courbe J, Garcia GA, Gil JF, Nahon L, Okumura M, Rutkowski L, Sims IR, Thiévin J, Le Picard SD. A new instrument for kinetics and branching ratio studies of gas phase collisional processes at very low temperatures. Rev Sci Instrum 2021; 92:014102. [PMID: 33514236 DOI: 10.1063/5.0029991] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
A new instrument dedicated to the kinetic study of low-temperature gas phase neutral-neutral reactions, including clustering processes, is presented. It combines a supersonic flow reactor with vacuum ultra-violet synchrotron photoionization time-of-flight mass spectrometry. A photoion-photoelectron coincidence detection scheme has been adopted to optimize the particle counting efficiency. The characteristics of the instrument are detailed along with its capabilities illustrated through a few results obtained at low temperatures (<100 K) including a photoionization spectrum of n-butane, the detection of formic acid dimer formation, and the observation of diacetylene molecules formed by the reaction between the C2H radical and C2H2.
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Affiliation(s)
- O Durif
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - M Capron
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - J P Messinger
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, California 91125, USA
| | - A Benidar
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - L Biennier
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - J Bourgalais
- LATMOS/IPSL, UVSQ, Université Paris-Saclay, UPMC, Univ Paris 06, CNRS, 78280 Guyancourt, France
| | - A Canosa
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - J Courbe
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - G A Garcia
- Synchrotron SOLEIL, L'orme des Merisiers, BP48 St Aubin, 91192 Gif Sur Yvette Cedex, France
| | - J F Gil
- Synchrotron SOLEIL, L'orme des Merisiers, BP48 St Aubin, 91192 Gif Sur Yvette Cedex, France
| | - L Nahon
- Synchrotron SOLEIL, L'orme des Merisiers, BP48 St Aubin, 91192 Gif Sur Yvette Cedex, France
| | - M Okumura
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, California 91125, USA
| | - L Rutkowski
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - I R Sims
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - J Thiévin
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
| | - S D Le Picard
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes) - UMR 6251, F-35000 Rennes, France
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21
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Okumura M, Hojo H, Nakamura N, Zenda S, Motegi A, Nakamura M, Hirano Y, Kageyama S, Raturi V, Akimoto T. PO-1261: Radiation pneumonitis after palliative radiotherapy in patients with interstitial lung disease. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01279-2] [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: 10/22/2022]
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22
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Shimoda M, Yamana K, Yano R, Saitou M, Fujiwara K, Furuuchi K, Osawa T, Uesugi F, Arakawa K, Morimoto K, Tanaka Y, Kokutou H, Okumura M, Uchiyama T, Ohta K, Yoshimori K. Analysis of risk factors for the development of a post-bronchoscopy respiratory infection in lung cancer patients. J Infect Chemother 2020; 27:237-242. [PMID: 33060045 DOI: 10.1016/j.jiac.2020.09.029] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/12/2020] [Accepted: 09/24/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND The development of pneumonia following bronchoscopy is a very important post-bronchoscopic complication, while lung abscesses after bronchoscopy are rare. However, bronchoscopic techniques have advanced, and recently, we have observed patients with lung abscess after bronchoscopy. Therefore, the risk factors might vary from those in past reports. This study was performed to identify the incidence of and risk factors for post-bronchoscopy respiratory infections. METHODS We retrospectively studied adult patients diagnosed with lung cancer by bronchoscopy at Fukujuji Hospital from January 2017 to June 2019. The infection and noninfection groups were compared. The incidence of lung abscess was compared between recent periods and 2013, when endobronchial ultrasonography with a guide sheath (EBUS-GS) was not yet used in our hospital. RESULTS We reviewed 327 patients, including 20 patients (6.1%) with infections. The risk factors for infection were necrosis and/or a cavity in the tumor (p < 0.001), a large tumor diameter (≥30 mm) (p = 0.010), and a low serum albumin level (<4.0 g/dL) (p = 0.010). We developed a predictive score with these risk factors, and the area under the curve was 0.737 (95% Cl: 0.610-0.864). No significant differences in age, current smoking status, or abnormal bronchoscopic findings were observed, although these were previously reported as risk factors. In total, 12 patients had lung abscesses (3.7%), which is a higher incidence than that in 2013 (0.8%). CONCLUSIONS The risk factors for developing post-bronchoscopy respiratory infection in our study varied from those in past reports, possibly because of the advancements in bronchoscopic techniques, such as EBUS-GS.
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Affiliation(s)
- Masafumi Shimoda
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan.
| | - Kazunari Yamana
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Ryozo Yano
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Masaoki Saitou
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Keiji Fujiwara
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Koji Furuuchi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Takeshi Osawa
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Fumiko Uesugi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Kenichi Arakawa
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Hiroyuki Kokutou
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Masao Okumura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Takashi Uchiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
| | - Kozo Yoshimori
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Kiyose City, Tokyo, Japan
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23
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Yoshiyama T, Mitarai S, Takaki A, Aono A, Okumura M, Ohta K, Kato S. Multi-drug resistant tuberculosis with simultaneously acquired-drug resistance to bedaquiline and delamanid. Clin Infect Dis 2020; 73:2329-2331. [PMID: 32730621 DOI: 10.1093/cid/ciaa1064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/25/2020] [Indexed: 11/13/2022] Open
Abstract
This study is the first to report a clinical case of simultaneously acquired resistance to bedaquiline (BDQ) and delamanid (DLM). Whole genome sequencing revealed two nucleotide insertions (Rv0678 and fbiC) in the Mycobacterium tuberculosis isolate. The minimum inhibitory concentrations for BDQ and DLM were 0.25 µg/ml and >2.0 µg/ml, respectively.
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Affiliation(s)
- Takashi Yoshiyama
- Research institute of tuberculosis and Fukujuji hospital, Tokyo Japan
| | - Satoshi Mitarai
- Department of mycobacterial reference and research, Research institute of tuberculosis, Tokyo, Japan
| | - Akiko Takaki
- Department of mycobacterial reference and research, Research institute of tuberculosis, Tokyo, Japan
| | - Akio Aono
- Department of mycobacterial reference and research, Research institute of tuberculosis, Tokyo, Japan
| | - Masao Okumura
- Respiratory diseases center, Fukujuji hospital, Tokyo, Japan
| | | | - Seiya Kato
- Research institute of tuberculosis, Tokyo, Japan
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24
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Iwasaki K, Hamana H, Kishi H, Yamamoto T, Hiramitsu T, Okad M, Tomosugi T, Takeda A, Narumi S, Watarai Y, Miwa Y, Okumura M, Matsuoka Y, Horimi K, Muraguchi A, Kobayash T. The suppressive effect on CD4 T cell alloresponse against endothelial HLA-DR via PD-L1 induced by anti-A/B ligation. Clin Exp Immunol 2020; 202:249-261. [PMID: 32578199 DOI: 10.1111/cei.13482] [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] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/27/2020] [Accepted: 06/15/2020] [Indexed: 11/27/2022] Open
Abstract
While donor-specific human leukocyte antigen (HLA) antibodies are a frequent cause for chronic antibody-mediated rejection in organ transplantation, this is not the case for antibodies targeting blood group antigens, as ABO-incompatible (ABO-I) organ transplantation has been associated with a favorable graft outcome. Here, we explored the role of CD4 T cell-mediated alloresponses against endothelial HLA-D-related (DR) in the presence of anti-HLA class I or anti-A/B antibodies. CD4 T cells, notably CD45RA-memory CD4 T cells, undergo extensive proliferation in response to endothelial HLA-DR. The CD4 T cell proliferative response was enhanced in the presence of anti-HLA class I, but attenuated in the presence of anti-A/B antibodies. Microarray analysis and molecular profiling demonstrated that the expression of CD274 programmed cell death ligand 1 (PD-L1) increased in response to anti-A/B ligation-mediated extracellular signal-regulated kinase (ERK) inactivation in endothelial cells that were detected even in the presence of interferon-γ stimulation. Anti-PD-1 antibody enhanced CD4 T cell proliferation, and blocked the suppressive effect of the anti-A/B antibodies. Educated CD25+ CD127- regulatory T cells (edu.Tregs ) were more effective at preventing CD4 T cell alloresponses to endothelial cells compared with naive Treg ; anti-A/B antibodies were not involved in the Treg -mediated events. Finally, amplified expression of transcript encoding PD-L1 was observed in biopsy samples from ABO-I renal transplants when compared with those from ABO-identical/compatible transplants. Taken together, our findings identified a possible factor that might prevent graft rejection and thus contribute to a favorable outcome in ABO-I renal transplantation.
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Affiliation(s)
- K Iwasaki
- Department of Kidney Disease and Transplant Immunology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - H Hamana
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - H Kishi
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - T Yamamoto
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - T Hiramitsu
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - M Okad
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - T Tomosugi
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - A Takeda
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - S Narumi
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Y Watarai
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Y Miwa
- Department of Kidney Disease and Transplant Immunology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - M Okumura
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Y Matsuoka
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - K Horimi
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - A Muraguchi
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - T Kobayash
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
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Okumura M, Yoshiyama T, Ogata H, Kurashima A, Yoshimori K, Ohta K, Kudoh S. Treatment of multidrug-resistant pulmonary tuberculosis with delamanid based on Japanese guideline recommendations. Respir Investig 2020; 58:110-116. [PMID: 31838040 DOI: 10.1016/j.resinv.2019.10.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/20/2019] [Accepted: 10/23/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND In Japan, a new anti-tuberculous drug, delamanid, was recognized as the drug of choice to treat multi-drug resistant pulmonary tuberculosis in July 2014. METHODS We treated 28 cases of multidrug-resistant tuberculosis (MDR-TB) and three cases of extensively drug-resistant tuberculosis (XDR-TB) with delamanid from July 2014 to June 2018 at our hospital. RESULTS There were 21 men and 10 women, with the mean age of 48 and 37 years, respectively. We used an average of 4.4 sensitive anti-tuberculous drugs for the MDR-TB cases and 4.7 for the XDR-TB cases with delamanid. We used linezolid in 19 of 31 cases, although it has not been recognized as an anti-tuberculous drug in Japan. On electrocardiography, QTc prolongation of more than 450 ms was seen in two cases (6.4%), but they were asymptomatic, thus the treatment with delamanid could be continued. In 10 cases, surgical resection was performed. We completed the treatment in 20 cases and continued the treatment in seven cases; however, the treatment was discontinued in four cases because of side effects. In all cases, the sputum cultures were negative. CONCLUSIONS Delamanid is a relatively safe drug with few side effects. However, some patients could not continue it because of difficulty of use in combination, therefore delamanid should be prescribed considering the side effects of all therapies in the regimen.
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Affiliation(s)
- Masao Okumura
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan.
| | - Takashi Yoshiyama
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Hideo Ogata
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Atsuyuki Kurashima
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Kozo Yoshimori
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Ken Ohta
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
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Miyagawa K, Kawakami T, Isobe H, Shoji M, Yamanaka S, Nakatani K, Okumura M, Nakajima T, Yamaguchi K. Domain-based local pair natural orbital CCSD(T) calculations of six different S1 structures of oxygen evolving complex of photosystem II. Proposal of multi-intermediate models for the S1 state. Chem Phys Lett 2019. [DOI: 10.1016/j.cplett.2019.136660] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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27
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Miyagawa K, Kawakami T, Suzuki Y, Isobe H, Shoji M, Yamanaka S, Okumura M, Nakajima T, Yamaguchi K. Domain-based local pair natural orbital CCSD(T) calculations of strongly correlated electron systems: Examination of dynamic equilibrium models based on multiple intermediates in S1 state of photosystem II. Mol Phys 2019. [DOI: 10.1080/00268976.2019.1666171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- K. Miyagawa
- Institute for Scientific and Industrial Research, Osaka University, Osaka 567-0047, Japan
| | - T. Kawakami
- Graduate School of Science, Osaka University, Toyonaka 560-0043, Japan
- RIKEN Center for Computational Science, Kobe, Hyogo 650-0047, Japan
| | - Y. Suzuki
- Graduate School of Science, Osaka University, Toyonaka 560-0043, Japan
| | - H. Isobe
- Graduate School of Natural Science and Technology, Okayama University, Okayama 700-8530, Japan
| | - M. Shoji
- Center of Computational Sciences, Tsukuba University, Tsukuba, Ibaraki 305-8577, Japan
| | - S. Yamanaka
- Graduate School of Science, Osaka University, Toyonaka 560-0043, Japan
| | - M. Okumura
- Graduate School of Science, Osaka University, Toyonaka 560-0043, Japan
| | - T. Nakajima
- RIKEN Center for Computational Science, Kobe, Hyogo 650-0047, Japan
| | - K. Yamaguchi
- Institute for Scientific and Industrial Research, Osaka University, Osaka 567-0047, Japan
- RIKEN Center for Computational Science, Kobe, Hyogo 650-0047, Japan
- Insitute for Nanoscience Design, Osaka University, Toyonaka 560-0043, Japan
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28
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Nakamura N, Zenda S, Motegi A, Arahira S, Hayashi R, Tahara M, Oyoshi H, Ariji T, Hojo H, Nakamura M, Parshuram R, Okumura M, Akimoto T. The Interval between Initial Surgery and Regional Recurrence May be a Predictive Factor of Local Recurrence in Patients with Oral Cavity Cancer Who Receive Postoperative Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1598] [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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29
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Yoshiyama T, Kurosaki A, Ogata H, Sasaki Y, Okumura M. Limited benefit of CT scans in tuberculosis contact tracing. J Infect Chemother 2019; 25:764-768. [PMID: 31101527 DOI: 10.1016/j.jiac.2019.03.023] [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: 09/19/2018] [Revised: 02/04/2019] [Accepted: 03/27/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The detection of abnormal findings on computed tomography (CT) scans of tuberculosis contacts combined with normal plain radiographs contributes to the early detection of tuberculosis. However, the benefit of the early detection of abnormalities for the prevention of active tuberculosis during follow-up requires evaluation. METHOD We conducted retrospective comparison of the existence of CT scans of tuberculosis contacts without findings of active tuberculosis on plain radiographs at a hospital in Japan. RESULTS Among 243 contacts without CT scans, five developed tuberculosis during follow-up. Among 229 contacts with CT scans, 24 were judged as targets of multi-drug therapy since their CT findings were suggestive of active tuberculosis at the time of the CT screening. Among 205 contacts judged as having latent tuberculous infection with CT screening, three developed tuberculosis diseases during follow-up. CONCLUSION CT scans detected abnormal findings among contacts without abnormalities of plain radiographs but there were some contacts that developed tuberculosis diseases among those with contact investigation including CT scan. The value of CT is equivocal considering the balance of true treatment, overtreatment and harm of radiation.
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Affiliation(s)
| | - Atsuko Kurosaki
- Department of Diagnostic Radiology, Fukujuji Hospital, Japan
| | | | - Yuka Sasaki
- Respiratory Diseases Center, Fukujuji Hospital, Japan
| | - Masao Okumura
- Respiratory Diseases Center, Fukujuji Hospital, Japan
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30
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Furuuchi K, Morimoto K, Yoshiyama T, Tanaka Y, Fujiwara K, Okumura M, Izumi K, Shiraishi Y, Mitarai S, Ogata H, Kurashima A, Yoshimori K, Ohta K, Goto H, Sasaki Y. Interrelational changes in the epidemiology and clinical features of nontuberculous mycobacterial pulmonary disease and tuberculosis in a referral hospital in Japan. Respir Med 2019; 152:74-80. [PMID: 31128614 DOI: 10.1016/j.rmed.2019.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 11/09/2018] [Revised: 04/01/2019] [Accepted: 05/04/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVES The incidence of nontuberculous mycobacterial pulmonary disease (NTM-PD) is increasing, while that of tuberculosis (TB) is decreasing in many industrialized countries, including Japan. However, the long-term evaluation of clinico-epidemiological features of NTM-PD in relation to TB are limited. We aimed to clarify the long-term changes in the epidemiology and clinical features of NTM-PD in relation to those of TB at a nationally-designated TB center in Japan. METHODS We reviewed all mycobacterial examination records at Fukujuji Hospital between 2006 and 2016. Cases of NTM-PD were defined according to the 2007 American Thoracic Society/Infectious Disease Society of America microbiologic criteria. The current characteristics of Mycobacterium avium complex pulmonary disease (MAC-PD) were compared with those in the 1980s and circa 2000. RESULTS We identified a total of 3,546 pulmonary TB cases and 2,155 NTM-PD cases. While the annual number of incident pulmonary TB cases remained stable over the study period (P = 0.59), that of NTM-PD cases increased significantly from 165 to 278 (P < 0.01). The mean age of pulmonary TB cases increased from 59.7 ± 16.3 to 66.2 ± 21.7 years, whereas that of NTM-PD cases remained unchanged. Regarding the age distribution, the greatest increases were observed in patients over 75 years for TB and in patients 50-74 years for NTM. The most common causative organism for NTM was Mycobacterium avium complex (87.3%), M. abscessus complex (5.5%) and M. kansasii (3.9%). Among patients with MAC-PD, the proportion of the nodular bronchiectatic (NB) form increased significantly from 60.0% to 84.4% between circa 2000 and 2016 (P < 0.01). Significant increases in the NB form were observed in both males (33.3%-70.7%, P < 0.01) and females (71.3%-89.2%, P < 0.01). CONCLUSIONS The annual number of incident NTM-PD cases increased markedly. In contrast to patients with TB, the mean age of new NTM-PD patients did not increase in the last 10 years. Among MAC-PD patients, the proportions accounted for by the NB form increased significantly in both sexes.
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Affiliation(s)
- Koji Furuuchi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan; Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Keiji Fujiwara
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Masao Okumura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kiyohiko Izumi
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yuji Shiraishi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Satoshi Mitarai
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Hideo Ogata
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Atsuyuki Kurashima
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kozo Yoshimori
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Hajime Goto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yuka Sasaki
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
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Abstract
Dexmedetomidine is a potent a2 adrenergic agonist, with sedative and analgesic properties which may make it a suitable sedative agent for procedures on paediatric patients. A six-year-old boy required sedation for stereotactic radiosurgical ablation of an arteriovenous malformation on two occasions. Sedation with dexmedetomidine was planned, with increased dosage used on the second occasion. On both occasions dexmedetomidine was inadequate as a sole agent and required supplementation with other agents.
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Affiliation(s)
- C J Fahy
- Division of Paediatric Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
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32
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Nakamoto K, Sasaki Y, Kokuto H, Okumura M, Yoshiyama T, Goto H. Multi-drug-resistant tuberculosis with galaxy and cluster signs on high-resolution computed tomography. Respirol Case Rep 2018; 6:e00369. [PMID: 30237890 PMCID: PMC6138543 DOI: 10.1002/rcr2.369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/12/2018] [Accepted: 08/21/2018] [Indexed: 11/13/2022] Open
Abstract
The galaxy sign and cluster sign were first reported in pulmonary sarcoidosis. From those reports, these two signs became known as one of the characteristic computed tomography (CT) findings of sarcoidosis. We report a patient with pulmonary tuberculosis who had these two signs. A 44-year-old man was referred to our hospital for general fatigue, cough, and low-grade fever lasting about two months. Thoracic CT showed a large parenchymal nodule arising from coalescent small nodules (galaxy sign) and clusters composed of numerous small nodules (cluster sign) in the bilateral lungs. Three specimens of sputum acid-fast smear were negative. However, we performed a bronchoscopy, and Mycobacterium tuberculosis was proven to be positive by the acid-fast culture test of the obtained bronchoalveolar lavage fluid. Moreover, drug sensitivity testing revealed this to be a case of multi-drug-resistant tuberculosis. Patients with these signs must be examined carefully to differentiate tuberculosis from pulmonary sarcoidosis.
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Affiliation(s)
- Keitaro Nakamoto
- Department of Respiratory MedicineFukujuji Hospital, Japan Anti‐Tuberculosis AssociationKiyoseJapan
| | - Yuka Sasaki
- Department of Respiratory MedicineFukujuji Hospital, Japan Anti‐Tuberculosis AssociationKiyoseJapan
| | - Hiroyuki Kokuto
- Department of Respiratory MedicineFukujuji Hospital, Japan Anti‐Tuberculosis AssociationKiyoseJapan
| | - Masao Okumura
- Department of Respiratory MedicineFukujuji Hospital, Japan Anti‐Tuberculosis AssociationKiyoseJapan
| | - Takashi Yoshiyama
- Department of Respiratory MedicineFukujuji Hospital, Japan Anti‐Tuberculosis AssociationKiyoseJapan
| | - Hajime Goto
- Department of Respiratory MedicineFukujuji Hospital, Japan Anti‐Tuberculosis AssociationKiyoseJapan
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33
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Sakura K, Lee C, Kaneda Y, Nakano T, Atagi S, Kadota Y, Kuribayashi K, Kuroyama M, Kijima T, Kumanogoh A, Okumura M. P1.14-19 Hemagglutinating Virus of Japan Envelope (HVJ-E: Inactivated Viral Nanoparticles) Against Chemotherapy-Resistant Pleural Mesothelioma. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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34
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Nagoya A, Kanzaki R, Ose N, Kanou T, Funaki S, Minami M, Shintani Y, Okumura M. P3.15-22 Validation of Eurolung Risk Models in a Japanese Population: A Retrospective Single-Center Analysis of 612 Cases. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1898] [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: 10/28/2022]
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35
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Kawai H, Ohta M, Motoyama S, Hashimoto Y, Nagahara Y, Hoshino M, Miyajima K, Ishikawa M, Okumura M, Naruse H, Takahashi H, Ishii J, Muramatsu T, Sarai M, Ozaki Y. 6182Does myocardial bridge assessed by coronary CT angiography predict vasospasm of left anterior descending? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.6182] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Kawai
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Ohta
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - S Motoyama
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - Y Hashimoto
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - Y Nagahara
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Hoshino
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - K Miyajima
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Ishikawa
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Okumura
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - H Naruse
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - H Takahashi
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - J Ishii
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - T Muramatsu
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Sarai
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - Y Ozaki
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
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36
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Kawakami T, Miyagawa K, Isobe H, Shoji M, Yamanaka S, Katouda M, Nakajima T, Nakatani K, Okumura M, Yamaguchi K. Relative stability between the manganese hydroxide- and oxo-models for water oxidation by CCSD, DMRG CASCI, CASSCF, CASPT2 and CASDFT methods; Importance of static and dynamical electron correlation effects for OEC of PSII. Chem Phys Lett 2018. [DOI: 10.1016/j.cplett.2018.05.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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37
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Ono R, Fukuta, Okumura M, Makiura D, Saito T, Inoue J, Sakai Y. Preoperative prevalence of multidimensional frailty and the associations with health-related quality of life in elderly cancer patients. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.666] [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: 10/28/2022]
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38
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Cachon T, Frykman O, Innes JF, Lascelles BDX, Okumura M, Sousa P, Staffieri F, Steagall PV, Van Ryssen B. Face validity of a proposed tool for staging canine osteoarthritis: Canine OsteoArthritis Staging Tool (COAST). Vet J 2018; 235:1-8. [PMID: 29704933 DOI: 10.1016/j.tvjl.2018.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/19/2018] [Accepted: 02/23/2018] [Indexed: 12/15/2022]
Affiliation(s)
- T Cachon
- Service de chirurgie, Campus vétérinaire de Lyon VetAgro-Sup, 1 avenue Bourgelat, 69280 Marcy l'Etoile, France; Unité de recherche ICE, UPSP 2007-03-135, VetAgro-Sup Campus vétérinaire, Université de Lyon, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France
| | | | - J F Innes
- CVS(UK) Ltd. ChesterGates Veterinary Specialists, Unit E, Telford Court, Gates Road, Chester CH1 6LT, UK
| | - B D X Lascelles
- Comparative Pain Research and Education Centre, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA; Center for Pain Research and Innovation, UNC School of Dentistry, Chapel Hill, NC, USA; Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA.
| | - M Okumura
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - P Sousa
- Hospital Veterinari Molins, Sant Vicenç dels Horts, Barcelona, Spain
| | - F Staffieri
- Section of Veterinary Clinics and Animal Production, D.E.O.T., 'Aldo Moro' University of Bari, Bari, Italy
| | - P V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada; Groupe de Recherche en Pharmacologie Animale du Québec, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - B Van Ryssen
- Department of Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Belgium
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39
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Fukuda M, Okumura M, Arimori K, Takahira A, Mori M, Nakamura D, Shimada M, Taniguchi H, Gyotoku H, Senju H, Ikeda T, Yamaguchi H, Nakatomi K, Tsuchiya T, Mukae H, Ashizawa K. P1.03-015 The Relationship between the UGT1A1*27 and UGT1A1*7 Genetic Polymorphisms and Irinotecan-Related Toxicities in Patients with Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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40
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Kimura K, Kanzaki R, Ose N, Kawamura T, Funaki S, Shintani Y, Minami M, Okumura M. MA 16.08 Surgery for Pleural Dissemination of Thymoma; A 20-Year Experience. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.602] [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: 10/18/2022]
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41
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Fujiwara A, Shintani Y, Funaki S, Kawamura T, Kanzaki R, Fukui E, Minami M, Okumura M. P1.02-068 Effects of Pirfenidone Targeting EMT and Tumor-Stroma Interaction as Novel Treatment for Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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42
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Kanzaki R, Naito H, Eino D, Kawamura T, Ose N, Funaki S, Shintani Y, Minami M, Okumura M, Takakura N. P3.16-050 Stromal PDGFR-β Expression Influences Postoperative Survival of NSCLC Patients Receiving Preoperative Chemo- or Chemo-Radiotherapy. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1857] [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: 11/28/2022]
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43
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Miyagawa K, Komi K, Ohnari J, Maruyama S, Yamanaka S, Saito T, Kawakami T, Yamaguchi K, Okumura M. Density functional study of the magneto-structural correlations of manganese complexes, [Mn2O2H (salpn)2]+(2−) (n= 0–2) from the viewpoint of the protonation modes of the bridging oxygen anions. Polyhedron 2017. [DOI: 10.1016/j.poly.2017.03.044] [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: 10/19/2022]
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44
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Funaki S, Shintani Y, Ose N, Kawamura T, Kanzaki R, Minami M, Okumura M. P1.17-013 Prognostic Impact of Programmed Cell Death-1 (PD-1) and PD-Ligand 1 (PD-L1) Expression in Thymic Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1095] [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: 10/18/2022]
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45
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Maniwa T, Shintani Y, Okami J, Ohta M, Takeuchi Y, Takami K, Yokouchi H, Kurokawa E, Kanzaki R, Sakamaki Y, Shiono H, Iwasaki T, Nishioka K, Kodama K, Okumura M. MA 17.04 Initial Surgery in Patients with Clinical N2 Non-Small Cell Lung Cancer: A Multi-Institution Retrospective Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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46
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Shintani Y, Funaki S, Kawamura T, Ose N, Kanzaki R, Kimura K, Yamamoto Y, Minami M, Okumura M. P1.17-002 Clinicopathological Significance of Epithelial Mesenchymal Transition in Thymic Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Endo S, Ikeda N, Kondo T, Nakajima J, Kondo H, Yokoi K, Chida M, Toyooka S, Sato M, Sato Y, Okada Y, Yoshida K, Okada M, Okumura M, Chihara K, Miyata H. O-056A LUNG CANCER SURGERY RISK MODEL OF 78 594 CASES FROM 2014 TO 2015 IN A JAPANESE NATIONWIDE WEB-BASED DATABASE. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sasaki Y, Yoshiyama T, Okumura M, Morimoto K, Miyamoto M, Yoshimori K, Kurashima A, Ogata H, Gotoh H. [THE FREQUENCIES AND MANAGEMENT OF ADVERSE REACTIONS IN MULTI-DRUG RESISTANT TUBERCULOSIS TREATMENT]. Kekkaku 2017; 92:11-19. [PMID: 30646468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
[Objectives] To investigate the adverse reactions of antimicrobial drugs in multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR- TB) patients. [Results] Sixty-six patients with MDR-TB who have been treated from 2010 through 2014 were evaluated in the retro- spective analysis. Variety of adverse reactions including psychological reaction, central nervous system toxicity, ophthalmic toxicity, peripheral neurotoxicity, gastrointestinal reactions, hematologic abnormalities, musculoskeletal adverse effects, and endocrine disorder, were observed. However, there was no fatal case due to the adverse reactions of the anti-tubercu- losis drugs in this observation. [Conclusions] Drugs for MDR-TB and XDR-TB treatment are limited and the adverse reactions of drugs for MDR-TB and XDR-TB are not well-known. Therefore, the treatment may fail due to inappropriate management of adverse events. MDR-TB and XDR-TB should be treated by the experts of the adverse reactions of all anti-tuberculosis drugs.
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Shiratori B, Zhao J, Okumura M, Chagan-Yasutan H, Yanai H, Mizuno K, Yoshiyama T, Idei T, Ashino Y, Nakajima C, Suzuki Y, Hattori T. Immunological Roles of Elevated Plasma Levels of Matricellular Proteins in Japanese Patients with Pulmonary Tuberculosis. Int J Mol Sci 2016; 18:ijms18010019. [PMID: 28025511 PMCID: PMC5297654 DOI: 10.3390/ijms18010019] [Citation(s) in RCA: 20] [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: 11/24/2016] [Revised: 12/16/2016] [Accepted: 12/16/2016] [Indexed: 01/17/2023] Open
Abstract
Elevated matricellular proteins (MCPs), including osteopontin (OPN) and galectin-9 (Gal-9), were observed in the plasma of patients with Manila-type tuberculosis (TB) previously. Here, we quantified plasma OPN, Gal-9, and soluble CD44 (sCD44) by enzyme-linked immunosorbent assay (ELISA), and another 29 cytokines by Luminex assay in 36 patients with pulmonary TB, six subjects with latent tuberculosis (LTBI), and 19 healthy controls (HCs) from Japan for a better understanding of the roles of MCPs in TB. All TB subjects showed positive results of enzyme-linked immunospot assays (ELISPOTs). Spoligotyping showed that 20 out of 36 Mycobacterium tuberculosis (MTB) strains belong to the Beijing type. The levels of OPN, Gal-9, and sCD44 were higher in TB (positivity of 61.1%, 66.7%, and 63.9%, respectively) than in the HCs. Positive correlations between OPN and Gal-9, between OPN and sCD44, and negative correlation between OPN and ESAT-6-ELISPOT response, between chest X-ray severity score of cavitary TB and ESAT-6-ELISPOT response were observed. Instead of OPN, Gal-9, and sCD44, cytokines G-CSF, GM-CSF, IFN-α, IFN-γ, IL-12p70, and IL-1RA levels were higher in Beijing MTB-infected patients. These findings suggest immunoregulatory, rather than inflammatory, effect of MCPs and can advance the understanding of the roles of MCPs in the context of TB pathology.
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Affiliation(s)
- Beata Shiratori
- Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Jingge Zhao
- Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Masao Okumura
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Haorile Chagan-Yasutan
- Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Hideki Yanai
- Department of Clinical Laboratory, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-2 4 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Kazue Mizuno
- Department of Clinical Laboratory, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-2 4 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Takashi Yoshiyama
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Tadashi Idei
- Department of Clinical Laboratory, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-2 4 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Yugo Ashino
- Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Chie Nakajima
- Division of Global Epidemiology, Research Center for Zoonosis Control, Hokkaido University, North 20, West 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.
| | - Yasuhiko Suzuki
- Division of Global Epidemiology, Research Center for Zoonosis Control, Hokkaido University, North 20, West 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.
| | - Toshio Hattori
- Department of Health Science and Social Welfare, Kibi International University, 8 Igamachi, Takahashi 716-8508, Japan.
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Okumura M, Yoshiyama T. [EXPERIENCE OF USE OF NEW ANTI-TUBERCULOUS DRUG, DELAMANID IN MULTI- AND EXTENSIVELY DRUG RESISTANT TUBERCULOSIS CASES IN OUR HOSPITAL]. Kekkaku 2016; 91:699-702. [PMID: 30648372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
[Objective] We experienced use of new anti- tuberculous drug, Delamanid in multi- and extensively drug resistant tuberculosis (M (X) DR-TB) in our hospital. [Materials and Methods] Fifteen cases who were diagnosed M(X)DR-TB had been used Delamanid in our hospital from 2014 to 2015. [Results] The gender distribution consisted of eleven males and four females in M(X)DR-TB. The mean age was 53.3 years old in male and 28.3 years old in female. Japanese were eight cases, and Chinese were five cases, and other countries patients were two cases. Twelve cases were MDR-TB cases, and three cases were XDR-TB cases. Six cases of fifteen cases were sputum culture positive before using Delamanid. Two cases (13.3%) had been appearanced QTc extension in EKG by using Delamanid. But these cases had not seen symptom. Other typical side effects had not seen. Six cases (40.0%) of fifteen cases had done surgical resection. One case of fifteen cases had been died with intractable pneumothorax, and one case had been discontinued for leukopenia. All cases containing two discontinued cases had obtained negative conversion of sputum culture. [Conclusion] We experienced new anti-tuberculous drug, Delamanid. If we add Delamanid only for MDR-TB patients with only one or two sensitive anti-tuberculous drugs, it will be possible to make anew resistance. We used one more another new drug, for example Linezolid or high dose isoniazid or Meropenem and Ampicilin Clavulanate acid with Delamanid and sensitive anti-tuberculous drugs. We need to investigate risk and benefit when we use new anti-tuberculous drug. We need not to make more another MDR-TB cases.
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