1
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Shirasaki K, Hifumi T, Sekiguchi M, Isokawa S, Nakao Y, Tanaka S, Hashiuchi S, Imai R, Otani N. Long-term psychiatric disorders in families of severe COVID-19 patients. Acute Med Surg 2024; 11:e926. [PMID: 38283103 PMCID: PMC10813578 DOI: 10.1002/ams2.926] [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: 05/22/2023] [Revised: 12/29/2023] [Accepted: 01/14/2024] [Indexed: 01/30/2024] Open
Abstract
Aim The present study aimed to describe in detail the changes to and assess the risk factors for poor long-term outcomes of psychiatric disorders in families of COVID-19 patients. Methods A single-center, retrospective study using questionnaires. Family members of patients admitted to the intensive care unit (ICU) with severe COVID-19 participated. Psychiatric disorders refer to the psychological distress such as anxiety, depression, and posttraumatic stress disorder (PTSD) experienced by the patient's family. Results Forty-six family members completed the survey and were analyzed. Anxiety, depression, and PTSD occurred in 24%, 33%, and 2% of family members, respectively, and psychiatric disorders occurred in 39%. On multivariable analysis, living in the same house with the patient was independently associated with a lower risk of psychiatric disorders in families of COVID-19 patients (OR, 0.180; 95% CI, 0.036-0.908; p = 0.038). Furthermore, four family members overcame psychiatric disorders, and six family members newly developed psychiatric disorders during the one-year follow-up period. Conclusion Approximately 40% of family members had long-term psychiatric disorders, and some of them overcame the psychiatric disorders, and some newly developed psychiatric disorders over the one-year follow-up. Living in the same house with the patient was possibly significantly associated with the reduction of long-term symptoms of psychiatric disorders, but this result must be interpreted with care. Further large studies are needed to examine the factors associated with the long-term mental status of family members.
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Affiliation(s)
- Kasumi Shirasaki
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Toru Hifumi
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Moe Sekiguchi
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Shutaro Isokawa
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Yusuke Nakao
- Department of NursingSt. Luke's International HospitalTokyoJapan
| | - Shinobu Tanaka
- Department of NursingSt. Luke's International HospitalTokyoJapan
| | | | - Ryosuke Imai
- Department of Pulmonary MedicineSt. Luke's International HospitalTokyoJapan
| | - Norio Otani
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
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2
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Oyama R, Ishigame H, Tanaka H, Tateshita N, Itazawa M, Imai R, Nishiumi N, Kishikawa JI, Kato T, Anindita J, Nishikawa Y, Maeki M, Tokeshi M, Tange K, Nakai Y, Sakurai Y, Okada T, Akita H. An Ionizable Lipid Material with a Vitamin E Scaffold as an mRNA Vaccine Platform for Efficient Cytotoxic T Cell Responses. ACS Nano 2023; 17:18758-18774. [PMID: 37814788 PMCID: PMC10569098 DOI: 10.1021/acsnano.3c02251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/17/2023] [Indexed: 10/11/2023]
Abstract
RNA vaccines based on lipid nanoparticles (LNPs) with in vitro transcribed mRNA (IVT-mRNA) encapsulated are now a currently successful but still evolving modality of vaccines. One of the advantages of RNA vaccines is their ability to induce CD8+ T-cell-mediated cellular immunity that is indispensable for excluding pathogen-infected cells or cancer cells from the body. In this study, we report on the development of LNPs with an enhanced capability for inducing cellular immunity by using an ionizable lipid with a vitamin E scaffold. An RNA vaccine that contained this ionizable lipid and an IVT-mRNA encoding a model antigen ovalbumin (OVA) induced OVA-specific cytotoxic T cell responses and showed an antitumor effect against an E.G7-OVA tumor model. Vaccination with the LNPs conferred protection against lethal infection by Toxoplasma gondii using its antigen TgPF. The vitamin E scaffold-dependent type I interferon response was important for effector CD8+ T cell differentiation induced by the mRNA-LNPs. Our findings also revealed that conventional dendritic cells (cDCs) were essential for achieving CD8+ T cell responses induced by the mRNA-LNPs, while the XCR1-positive subset of cDCs, cDC1 specialized for antigen cross-presentation, was not required. Consistently, the mRNA-LNPs were found to selectively transfect another subset of cDCs, cDC2 that had migrated from the skin to lymph nodes, where they could make vaccine-antigen-dependent contacts with CD8+ T cells. The findings indicate that the activation of innate immune signaling by the adjuvant activity of the vitamin E scaffold and the expression of antigens in cDC2 are important for subsequent antigen presentation and the establishment of antigen-specific immune responses.
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Affiliation(s)
- Ryotaro Oyama
- Laboratory
of DDS Design and Drug Disposition, Graduate School of Pharmaceutical
Sciences, Chiba University, 1-8-1 Inohana,
Chuo-ku, Chiba City, Chiba, 260-0856, Japan
| | - Harumichi Ishigame
- Laboratory
for Tissue Dynamics, RIKEN Center for Integrative
Medical Sciences, 1-7-22
Suehiro-cho, Tsurumi-ku, Yokohama City, Kanagawa 230-0045, Japan
| | - Hiroki Tanaka
- Laboratory
of DDS Design and Drug Disposition, Graduate School of Pharmaceutical
Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai City, Miyagi 980-8578, Japan
| | - Naho Tateshita
- Laboratory
of DDS Design and Drug Disposition, Graduate School of Pharmaceutical
Sciences, Chiba University, 1-8-1 Inohana,
Chuo-ku, Chiba City, Chiba, 260-0856, Japan
| | - Moeko Itazawa
- Laboratory
for Tissue Dynamics, RIKEN Center for Integrative
Medical Sciences, 1-7-22
Suehiro-cho, Tsurumi-ku, Yokohama City, Kanagawa 230-0045, Japan
| | - Ryosuke Imai
- Laboratory
for Tissue Dynamics, RIKEN Center for Integrative
Medical Sciences, 1-7-22
Suehiro-cho, Tsurumi-ku, Yokohama City, Kanagawa 230-0045, Japan
- Division
of Physiological Chemistry and Metabolism, Graduate School of Pharmaceutical
Sciences, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Naomasa Nishiumi
- Laboratory
of DDS Design and Drug Disposition, Graduate School of Pharmaceutical
Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai City, Miyagi 980-8578, Japan
| | - Jun-ichi Kishikawa
- Laboratory
for Cryo-EM Structural Biology, Institute for Protein Research, Osaka University, 3-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takayuki Kato
- Laboratory
for Cryo-EM Structural Biology, Institute for Protein Research, Osaka University, 3-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Jessica Anindita
- Laboratory
of DDS Design and Drug Disposition, Graduate School of Pharmaceutical
Sciences, Chiba University, 1-8-1 Inohana,
Chuo-ku, Chiba City, Chiba, 260-0856, Japan
| | - Yoshifumi Nishikawa
- National
Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Nishi 2-13, Inada-cho, Obihiro City, Hokkaido 080-8555, Japan
| | - Masatoshi Maeki
- Division
of Applied Chemistry, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo City, Hokkaido 060-8628, Japan
| | - Manabu Tokeshi
- Division
of Applied Chemistry, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo City, Hokkaido 060-8628, Japan
| | - Kota Tange
- DDS
Research Laboratory, NOF CORPORATION, 3-3 Chidori-cho, Kawasaki-ku, Kawasaki City, Kanagawa 210-0865, Japan
| | - Yuta Nakai
- DDS
Research Laboratory, NOF CORPORATION, 3-3 Chidori-cho, Kawasaki-ku, Kawasaki City, Kanagawa 210-0865, Japan
| | - Yu Sakurai
- Laboratory
of DDS Design and Drug Disposition, Graduate School of Pharmaceutical
Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai City, Miyagi 980-8578, Japan
| | - Takaharu Okada
- Laboratory
for Tissue Dynamics, RIKEN Center for Integrative
Medical Sciences, 1-7-22
Suehiro-cho, Tsurumi-ku, Yokohama City, Kanagawa 230-0045, Japan
- Graduate
School of Medical Life Science, Yokohama
City University, 1-7-29
Suehiro-cho, Tsurumi-ku, Yokohama City, Kanagawa 230-0045, Japan
| | - Hidetaka Akita
- Laboratory
of DDS Design and Drug Disposition, Graduate School of Pharmaceutical
Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai City, Miyagi 980-8578, Japan
- Center
for Advanced Modalities and DDS, Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan
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Imai R, Kitamura A. Successful treatment with atezolizumab in a haemodialysis patient with large cell neuroendocrine carcinoma. Respirol Case Rep 2023; 11:e01193. [PMID: 37484711 PMCID: PMC10356775 DOI: 10.1002/rcr2.1193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023] Open
Abstract
In this report, a modified regimen based on IMpower 133 (carboplatin + etoposide + atezolizumab) was administered to a patient diagnosed with large cell neuroendocrine carcinoma (LCNEC) who was concurrently undergoing haemodialysis. Adverse events led to the discontinuation of carboplatin and etoposide after the first course. Nevertheless, the patient exhibited reduction in pulmonary nodule and adrenal metastasis while receiving atezolizumab, indicating its sustained efficacy for a duration of 7 months. To the best of our knowledge, this is the first documented case demonstrating successful treatment with atezolizumab in LCNEC patients undergoing haemodialysis. Atezolizumab can be administered safely in patients undergoing dialysis and is a promising therapeutic option for dialysis patients with LCNEC.
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Affiliation(s)
- Ryosuke Imai
- Department of Pulmonary MedicineSt. Luke's International HospitalTokyoJapan
| | - Atsushi Kitamura
- Department of Pulmonary MedicineSt. Luke's International HospitalTokyoJapan
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4
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Nakamura T, Imai R, Kitamura A, So C, Ro S, Okafuji K, Tomishima Y, Jinta T, Nishimura N. Investigating Viral Involvement in Immunocompromised Patients Using Comprehensive Infectious Disease Testing Including FilmArray Respiratory Panel 2.1 on Bronchoscopy: A Retrospective Study. Cureus 2023; 15:e38820. [PMID: 37303378 PMCID: PMC10256251 DOI: 10.7759/cureus.38820] [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] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Reports are rare on the usefulness of the FilmArray Respiratory Panel 2.1 (FARP) using lower respiratory tract specimens. This retrospective study assessed its use, as part of a comprehensive infectious disease panel, to detect the viral causes of pneumonia using bronchoalveolar lavage samples from immunosuppressed patients. Methods This study included immunocompromised patients who underwent bronchoalveolar lavage or bronchial washing by bronchoscopy between April 1, 2021, and April 30, 2022. The collected samples were submitted for comprehensive testing, including FARP test; reverse transcription polymerase chain reaction (RT-PCR) for cytomegalovirus, varicella-zoster virus DNA, and herpes simplex virus; PCR for Pneumocystis jirovecii DNA; antigen testing for Aspergillus and Cryptococcus neoformans; and loop-mediated isothermal amplification method for Legionella. Results Out of 23 patients, 16 (70%) showed bilateral infiltrative shadows on computed tomography and three (13%) were intubated. The most common causes of immunosuppression were anticancer drug use (n=12, 52%) and hematologic tumors (n=11, 48%). Only two (9%) patients tested positive for severe acute respiratory syndrome coronavirus 2 and adenovirus by FARP. Four patients (17%) tested positive for cytomegalovirus by RT-PCR, but no inclusion bodies were identified cytologically. Nine (39%) patients tested positive for Pneumocystis jirovecii by PCR, but cytology confirmed the organism in only one case. Conclusions Comprehensive infectious disease testing, performed using bronchoalveolar lavage samples collected from lung lesions in immunosuppressed patients, showed low positive detection by FARP. The viruses currently detectable by FARP may be less involved in viral pneumonia diagnosed in immunocompromised patients.
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Affiliation(s)
- Tomoaki Nakamura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Atsushi Kitamura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Clara So
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Shosei Ro
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Kohei Okafuji
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Yutaka Tomishima
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Torahiko Jinta
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Naoki Nishimura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
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5
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Imai R, Tsuchida Y, Jinta T. Sarcoidosis or sarcoid-like reaction with mediastinal lymphadenopathy in patients after breast cancer surgery. Respir Investig 2023; 61:398-404. [PMID: 37099890 DOI: 10.1016/j.resinv.2023.03.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/21/2023] [Accepted: 03/12/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Patients with breast cancer present with lymphadenopathy involving non-caseating epithelioid cell granulomas in the mediastinum or axilla, referred to as sarcoidosis or sarcoid-like reactions (SLRs). However, sarcoidosis/SLRs prevalence and clinical presentation remain unclear. This study aimed to determine the frequency and clinical presentation of sarcoidosis/SLRs among postoperative patients with breast cancer. METHODS Among all patients who underwent surgery for early-stage breast cancer at St. Luke's International Hospital in Japan between 2010 and 2021, those who subsequently developed enlarged mediastinal lymph nodes and underwent bronchoscopy for suspected breast cancer recurrence were included. Patients were classified into sarcoidosis/SLR or metastatic breast cancer groups, and the clinical characteristics were compared. RESULTS A total of 9,559 patients underwent breast cancer surgery; bronchoscopy was performed to diagnose enlarged mediastinal lymph nodes in 29 cases. Breast cancer recurrence was observed in 20 patients. Eight women with a median age of 49 years (range 38-75) and a median time from surgery to diagnosis of 4.0 years (range 0.2-10.8) were diagnosed with sarcoidosis/SLRs. Four of the eight patients underwent mammoplasty with silicone breast implants (SBIs), and two experienced postoperative recurrences of breast cancer before or after lymphadenopathy, which was considered inciting factors for SLRs. The remaining two cases could have developed sarcoidosis after breast cancer surgery with no underlying causes for SLR. CONCLUSIONS Postoperative sarcoidosis/SLRs rarely occur in patients with breast cancer. An adjuvant action of SBI likely contributed to the progression of SLRs; few cases exhibited a causal relationship with breast cancer recurrence.
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Affiliation(s)
- Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan.
| | - Yasue Tsuchida
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
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6
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Yamada D, Imai R, Matsusako M, Kurihara Y. Intravascular large B-cell lymphoma appearance on dual-energy computed tomography: a case report. BMC Pulm Med 2023; 23:125. [PMID: 37072746 PMCID: PMC10111646 DOI: 10.1186/s12890-023-02420-9] [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: 05/31/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Intravascular large B-cell lymphoma (IVLBCL) is the proliferation of neoplastic B lymphocytes in the vascular space. Since conventional computed tomography (CT) shows nonspecific findings, differentiation between IVLBCL and other lung diseases, such as diffuse interstitial lung disease, is difficult. CASE PRESENTATION A 73-year-old man presented with dyspnea and hypoxemia. Laboratory findings showed an increased lactate dehydrogenase level of 1690 U/L (normal: 130-235 U/L) and soluble interleukin-2 receptor level of 1140 U/mL (normal: 157-474U/mL). Dual-energy CT iodine mapping showed a significant symmetrical decrease in iodine distribution in the upper lungs, suggesting an unusual distribution of pulmonary hypoperfusion. Therefore, IVLBCL was suspected. A random skin biopsy confirmed the diagnosis of IVLBCL. Due to the severity of the disease, lung biopsy was averted. After admission to the hospital, high-dose methotrexate was administered for central nervous system involvement, due to findings of suspected intracranial infiltration on a brain magnetic resonance imaging and elevated cell counts on lumbar puncture. Subsequently, oxygen demand improved, and rituximab along with cyclophosphamide, doxorubicin, vincristine, and prednisone was added to the patient's regime. Eventually, oxygen administration was terminated, the patient's general condition improved, and the patient was discharged after 47 days of hospitalization. CONCLUSIONS Since the diagnosis of IVLBCL depends on whether it is possible to suspect IVLBCL, the finding of decreased iodine perfusion demonstrated on dual-energy CT is considered important information for diagnosis. An immediate diagnosis of IVLBCL is needed to avoid rapid disease progression and introduce early treatment for a favorable prognosis. In this case, unique pulmonary hypoperfusion demonstrated by dual-energy CT promoted early diagnosis of IVLBCL.
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Affiliation(s)
- Daisuke Yamada
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan.
| | - Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Masaki Matsusako
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Yasuyuki Kurihara
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
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7
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Shirasaki K, Hifumi T, Goto M, Shin K, Horie K, Isokawa S, Inoue A, Sakamoto T, Kuroda Y, Imai R, Otani N. Clinical characteristics and outcomes after extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients with an initial asystole rhythm. Resuscitation 2023; 183:109694. [PMID: 36646370 DOI: 10.1016/j.resuscitation.2023.109694] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/26/2022] [Revised: 12/29/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
AIM This study aimed to describe the characteristics of cases of out-of-hospital cardiac arrest (OHCA) with an initial asystole rhythm in which extracorporeal cardiopulmonary resuscitation (ECPR) was introduced and discuss the clinical indications for ECPR in such patients. METHODS This was a secondary analysis of the SAVE-J II study, a retrospective, multicentre, registry study involving 36 participating institutions in Japan. Patients with an initial asystole rhythm were selected. Favourable neurological outcomes (cerebral performance categories 1-2) constituted the primary outcome. RESULTS In total, 202 patients met the inclusion criteria, with favourable neurological outcomes at hospital discharge in 12 patients (5.9%). Causes of cardiac arrest with favourable neurological outcomes were hypothermia (7 cases), acute coronary syndrome (2 cases), arrhythmia (2 cases), and pulmonary embolism (1 case). Among patients with non-hypothermia (temperature ≥32 °C) on hospital arrival with the cardiac rhythm of asystole or pulseless electrical activity (PEA) on arrival, all 107 patients (66 asystole, 41 PEA) who lacked one or more of the requirements (witness; bystander CPR; signs of life or pupil < 5 mm) had unfavourable neurological outcomes. All 5 cases with favourable neurological outcomes, except for 1 case with a short duration of no-flow time that was highly suspected based on the patient's history, met all the requirements on hospital arrival. CONCLUSIONS A total of 202 ECPR cases with an initial asystole rhythm, including 12 patients with favourable neurological outcomes, were described. Even if the initial cardiac rhythm is asystole, ECPR could be considered if certain conditions are met.
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Affiliation(s)
- Kasumi Shirasaki
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.
| | - Masahiro Goto
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Kijong Shin
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Katsuhiro Horie
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Shutaro Isokawa
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Akihiko Inoue
- Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, Japan
| | - Tetsuya Sakamoto
- Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Yasuhiro Kuroda
- Department of Emergency Medicine, Kagawa University School of Medicine, Kagawa, Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Norio Otani
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
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8
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Mukai K, Tsunoda H, Imai R, Numata A, Kida K, Oba K, Yagishita K, Yamauchi H, Kanomata N, Kurihara Y. The location of unilateral axillary lymphadenopathy after COVID-19 vaccination compared with that of metastasis from breast cancer without vaccination. Jpn J Radiol 2023; 41:617-624. [PMID: 36626076 PMCID: PMC9830608 DOI: 10.1007/s11604-023-01387-1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
PURPOSE Unilateral axillary lymphadenopathy is known to occur after coronavirus disease (COVID-19) vaccination. Post-vaccination lymphadenopathy may mimic the metastatic lymph nodes in breast cancer, and it is challenging to distinguish between them. This study investigated whether the localization of axillary lymphadenopathy on magnetic resonance imaging (MRI) could be used to distinguish reactive lymphadenopathy after COVID-19 vaccines from metastatic nodes. MATERIALS AND METHODS We retrospectively examined preoperative MRI images of 684 axillae in 342 patients who underwent breast cancer surgery from June to October 2021. Lymphadenopathy was defined as cortical thickening or short axis ≥ 5 mm. The axilla was divided into ventral and dorsal parts on the axial plane using a perpendicular line extending from the most anterior margin of the muscle group, including the deltoid, latissimus dorsi, or teres major muscles, relative to a line along the lateral chest wall. We recorded the presence or absence of axillary lymphadenopathy in each area and the number of visible lymph nodes. RESULTS Of 80 axillae, 41 and 39 were included in the vaccine and metastasis groups, respectively. The median time from the last vaccination to MRI was 19 days in the vaccine group. The number of visible axillary lymph nodes was significantly higher in the vaccine group (median, 15 nodes) than in the metastasis group (7 nodes) (P < 0.001). Dorsal lymphadenopathy was observed in 16 (39.0%) and two (5.1%) axillae in the vaccine and metastasis groups, respectively (P < 0.001). If the presence of both ventral and dorsal lymphadenopathy is considered indicative of vaccine-induced reaction, this finding has a sensitivity of 34.1%, specificity of 97.4%, and positive and negative predictive values of 93.3% and 58.5%, respectively. CONCLUSION The presence of deep axillary lymphadenopathy may be an important factor for distinguishing post-vaccination lymphadenopathy from metastasis. The number of axillary lymph nodes may also help.
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Affiliation(s)
- Kiyoko Mukai
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan.
| | - Hiroko Tsunoda
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Akiko Numata
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Kumiko Kida
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Ken Oba
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Kazuyo Yagishita
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Naoki Kanomata
- Department of Pathology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Yasuyuki Kurihara
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-8560, Japan
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9
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Morita C, Kitamura A, Kinoshita K, Sueyoshi K, Murakami M, Ro S, Imai R, Okafuji K, Kojima F, Tomishima Y, Jinta T, Bando T, Nishimura N. A case of a thoracic mass negative on thoracentesis diagnosed by cryobiopsy from the visceral pleura. Respirol Case Rep 2022; 10:e01050. [PMID: 36268501 PMCID: PMC9577260 DOI: 10.1002/rcr2.1050] [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: 08/08/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022] Open
Abstract
Thoracoscopy under local anaesthesia is recommended for malignant tumours with negative pleural effusion cytology. Cryobiopsy from the visceral pleura by thoracoscopy under local anaesthesia can provide more diagnostic options for patients with thoracentesis‐negative malignant effusions. Here we present the first case in which this technique was used. The patient had a pleural metastasis that could not be diagnosed even with rapid cytology of the parietal pleura biopsy. Indications, technical pitfalls, and safety tips are discussed.
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Affiliation(s)
- Chie Morita
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan,Department of Respiratory MedicineNational Center for Global Health and MedicineTokyoJapan
| | - Atsushi Kitamura
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Katsuhito Kinoshita
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Kuniyo Sueyoshi
- Department of Thoracic Surgery, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Manabu Murakami
- Department of Anesthesia and Intensive Care UnitSt. Luke's International HospitalTokyoJapan
| | - Shosei Ro
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Ryosuke Imai
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Kohei Okafuji
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Fumitsugu Kojima
- Department of Thoracic Surgery, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Yutaka Tomishima
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Torahiko Jinta
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Toru Bando
- Department of Thoracic Surgery, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Naoki Nishimura
- Department of Respiratory Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
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10
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Nakamura T, Imai R, Nishimura N. A Case of Nonsmall-Cell Lung Cancer with Anaphylaxis after 41 Courses of Pembrolizumab along with Adrenal Insufficiency as an Immune-Related Adverse Event. Case Rep Oncol 2022; 15:804-808. [PMID: 36825102 PMCID: PMC9941790 DOI: 10.1159/000526561] [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: 07/17/2022] [Accepted: 08/04/2022] [Indexed: 11/19/2022] Open
Abstract
In this report, we present a case of nonsmall-cell lung cancer with anaphylaxis after 41 courses of pembrolizumab along with adrenal insufficiency as an immune-related adverse event (irAE). A 73-year-old man with no allergic disease started pembrolizumab for postoperative recurrence of lung cancer. After four courses, tumor shrinkage was observed and maintained thereafter. After the 39th course, his serum sodium level and random serum cortisol level decreased. Adrenal insufficiency was considered; however, the patient was asymptomatic. Furthermore, his serum sodium level improved spontaneously; therefore, he was followed up. At the end of the 40th course, rhinorrhea and pharyngeal discomfort were noted; however, they were mild and resolved spontaneously. Immediately after administration of the 41st course, he developed pembrolizumab-induced anaphylaxis with percutaneous oxygen saturation decreased. The symptoms quickly improved after intramuscular adrenaline were administered and did not recur. Three months after discharge, the patient was urgently examined for vomiting and anorexia. His serum sodium levels decreased to 119 mEq/L, and an adrenocorticotropic hormone stimulation test was performed. It showed a low response, and the patient was diagnosed with secondary adrenal insufficiency as an irAE of pembrolizumab and treated with hydrocortisone, which quickly improved his serum sodium levels and symptoms. When adrenal insufficiency develops due to irAEs, patients may be susceptible to allergic reactions.
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Affiliation(s)
| | - Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Naoki Nishimura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
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11
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Imai R, Yamada D, Tomishima Y, Nakamura T, So C, Ro S, Okafuji K, Kitamura A, Jinta T, Nishimura N. Elevated plasma levels of Krebs von den Lungen-6 and geographic appearance on high-resolution computed tomography are associated with diffuse alveolar damage in autopsy cases of acute respiratory distress syndrome: a retrospective study. BMC Pulm Med 2022; 22:308. [PMID: 35953795 PMCID: PMC9367020 DOI: 10.1186/s12890-022-02102-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background Although diffuse alveolar damage (DAD) is a histopathological hallmark of acute respiratory distress syndrome (ARDS), its detection without lung biopsy is challenging. In patients with ARDS, the specificity of the Berlin definition to diagnose DAD as a reference standard is not adequately high, making it difficult to adequately diagnose DAD. The purpose of this study was to investigate the relationship between DAD and clinical findings, including KL-6 and geographic appearance, in ARDS patients and to identify more specific diagnostic criteria for DAD. Methods Among all adult autopsy cases at a tertiary hospital in Japan between January 2006 and March 2021, patients with ARDS who met the Berlin definition criteria were included. The patients’ conditions were classified according to histopathological patterns as DAD or non-DAD, and clinical characteristics, laboratory data, and high-resolution computed tomography (HRCT) findings were compared between the two groups. Results During the study period, 27 met the Berlin definition (median age: 79 years, 19 men), of whom 18 (67%) had DAD and 9 (33%) did not. In the non-DAD group, histopathologic findings revealed organizing pneumonia in seven patients and pulmonary hemorrhage in two patients. On HRCT at onset, patients with DAD had more geographic appearance than those without DAD (89% vs. 44%). In patients with geographic appearance and elevated KL-6 (> 500 U/mL), the sensitivity and specificity for DAD diagnosis were 56% and 100%, respectively. All three patients with no geographic appearance and normal KL-6 did not have DAD. Conclusions Geographic appearance on HRCT combined with KL-6 levels may predict the presence of DAD in patients with ARDS.
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Affiliation(s)
- Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
| | - Daisuke Yamada
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Yutaka Tomishima
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Tomoaki Nakamura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Clara So
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Shosei Ro
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Kohei Okafuji
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Atsushi Kitamura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Naoki Nishimura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
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12
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Kanemura H, Hayashi H, Tomida S, Tanizaki J, Suzuki S, Kawanaka Y, Tsuya A, Fukuda Y, Kaneda H, Kudo K, Takahama T, Imai R, Haratani K, Chiba Y, Otani T, Ito A, Sakai K, Nishio K, Nakagawa K. The Tumor Immune Microenvironment and Frameshift Neoantigen Load Determine Response to PD-L1 Blockade in Extensive-Stage SCLC. JTO Clin Res Rep 2022; 3:100373. [PMID: 35941997 PMCID: PMC9356091 DOI: 10.1016/j.jtocrr.2022.100373] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/06/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hiroaki Kanemura
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
- Corresponding author. Address for correspondence: Hidetoshi Hayashi, MD, PhD, Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.
| | - Shuta Tomida
- Center for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Junko Tanizaki
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
- Department of Medical Oncology, Kishiwada City Hospital, Osaka, Japan
| | - Shinichiro Suzuki
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
- Department of Medical Oncology, Kishiwada City Hospital, Osaka, Japan
| | - Yusuke Kawanaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
- Department of Medical Oncology, Kishiwada City Hospital, Osaka, Japan
| | - Asuka Tsuya
- Department of Medical Oncology, Izumi City General Hospital, Osaka, Japan
| | - Yasushi Fukuda
- Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Keita Kudo
- Department of Thoracic Medical Oncology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan
| | - Takayuki Takahama
- Department of Medical Oncology, Kindai University Nara Hospital, Nara, Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke’s International Hospital, Tokyo, Japan
| | - Koji Haratani
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kindai University Hospital, Osaka, Japan
| | - Tomoyuki Otani
- Department of Pathology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Akihiko Ito
- Department of Pathology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuko Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
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13
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Kitamura A, Tomishima Y, Imai R, Nishimura N, Okafuji K, Ro S, Jinta T, Tamura T. Findings of virtual bronchoscopic navigation can predict the diagnostic rate of primary lung cancer by bronchoscopy in patients with peripheral lung lesions. BMC Pulm Med 2022; 22:270. [PMID: 35836220 PMCID: PMC9284836 DOI: 10.1186/s12890-022-02071-2] [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: 01/11/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite being minimally invasive, bronchoscopy does not always result in pathological specimens being obtained. Therefore, we investigated whether virtual bronchoscopic navigation (VBN) findings were associated with the rate of diagnosis of primary lung cancer by bronchoscopy in patients with peripheral lung lesions. METHODS This study included patients with suspected malignant peripheral lung lesions who underwent bronchoscopy at St. Luke's International Hospital between October 2013 and March 2020. Patients diagnosed with primary lung cancer were grouped according to whether their pathology could be diagnosed by bronchoscopy, and their clinical factors were compared. In addition, the distance between the edge of the lesion and the nearest branch ("distance by VBN") was calculated. The distance by VBN and various clinical factors were compared with the diagnostic rates of primary lung cancer. RESULTS The study included 523 patients with 578 lesions. After excluding 55 patients who underwent multiple bronchoscopies, 381 patients were diagnosed with primary lung cancer. The diagnostic rate by bronchoscopy was 71.1% (271/381). Multivariate analysis revealed that the lesion diameter (odds ratio [OR] 1.107), distance by VBN (OR 0.94) and lesion structure (solid lesion or ground-glass nodule; OR 2.988) influenced the risk of a lung cancer diagnosis. The area under the receiver operating characteristic curve for diagnosis based on lesion diameter and distance by VBN was 0.810. CONCLUSION The distance by VBN and lesion diameter were predictive of the diagnostic rates of primary lung cancer by bronchoscopy in patients with peripheral lung lesions.
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Affiliation(s)
- Atsushi Kitamura
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Akashicho 9-1, Chuo City, Tokyo, 104-8560, Japan.
| | - Yutaka Tomishima
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Akashicho 9-1, Chuo City, Tokyo, 104-8560, Japan
| | - Ryosuke Imai
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Akashicho 9-1, Chuo City, Tokyo, 104-8560, Japan
| | - Naoki Nishimura
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Akashicho 9-1, Chuo City, Tokyo, 104-8560, Japan
| | - Kohei Okafuji
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Akashicho 9-1, Chuo City, Tokyo, 104-8560, Japan
| | - Shosei Ro
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Akashicho 9-1, Chuo City, Tokyo, 104-8560, Japan
| | - Torahiko Jinta
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Akashicho 9-1, Chuo City, Tokyo, 104-8560, Japan
| | - Tomohide Tamura
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Akashicho 9-1, Chuo City, Tokyo, 104-8560, Japan
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14
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Kitadai R, Asao T, Shukuya T, Yamamoto G, Mouri A, Imai R, Tsukita Y, Isobe K, Watanabe S, Kamimura M, Morita R, Kudo K, Inomata M, Tateishi K, Kakinuma K, Yoshioka H, Namba Y, Nakagawa T, Kobayashi K, Takahashi K. MO4-4 Safety of immune checkpoint blockade in lung cancer and pre-existing autoimmune diseases: NEJ047 multi-center study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.05.106] [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: 11/01/2022] Open
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15
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Tamura A, Imai R, Tomishima Y, Nishimura N. Progressive pulmonary fibrosis due to diffuse alveolar damage in a
COVID
‐19‐infected autopsy case. Respirol Case Rep 2022; 10:e0934. [PMID: 35342636 PMCID: PMC8926900 DOI: 10.1002/rcr2.934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 12/15/2022] Open
Abstract
We encountered a patient with severe coronavirus disease 2019 (COVID‐19)‐related pneumonia, who died of progressive respiratory acidosis after 2 months of treatment with mechanical ventilation. The autopsy revealed diffuse alveolar damage (DAD) without any active signs of fungal or bacterial infections, suggesting prolonged and over‐activated immune responses against COVID‐19 infection. When COVID‐19 patients develop acute respiratory distress syndrome, it is essential to remember that the infection can progress to DAD a few months after the disease onset.
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Affiliation(s)
- Akiko Tamura
- Department of Pulmonary Medicine St. Luke's International Hospital Tokyo Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine St. Luke's International Hospital Tokyo Japan
| | - Yutaka Tomishima
- Department of Pulmonary Medicine St. Luke's International Hospital Tokyo Japan
| | - Naoki Nishimura
- Department of Pulmonary Medicine St. Luke's International Hospital Tokyo Japan
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16
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Morita C, Kitamura A, Okafuji K, Ro S, Imai R, Shirasaki K, Watanabe Y, Nishimura N. Combined treatment with endobronchial Watanabe spigot and
N
‐butyl‐2‐cyanoacrylate for refractory pneumothorax in
COVID
‐19. Respirol Case Rep 2022; 10:e0923. [PMID: 35309960 PMCID: PMC8918464 DOI: 10.1002/rcr2.923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 01/04/2023] Open
Abstract
Coronavirus disease 2019 (COVID‐19) causes pneumothorax or mediastinal emphysema in approximately 1% of patients. According to the British Thoracic Society guidelines, the next treatment option for patients with persistent pneumothorax despite chest drainage is pleurodesis or surgery. In fact, there are reports of autologous blood pleurodesis or surgery for the treatment of pneumothorax caused by COVID‐19. However, elderly patients or patients in poor general condition may not be able to tolerate surgical invasion. In this report, we present two patients who did not respond to chest drainage or pleurodesis and who were not suitable for surgery because of their poor general condition. These patients were successfully treated with an endobronchial Watanabe spigot and N‐butyl‐2‐cyanoacrylate. This method may be an option for the treatment of refractory pneumothorax in COVID‐19.
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Affiliation(s)
- Chie Morita
- Department of Pulmonary Medicine Thoracic Center, St. Luke's International Hospital Tokyo Japan
| | - Atsushi Kitamura
- Department of Pulmonary Medicine Thoracic Center, St. Luke's International Hospital Tokyo Japan
| | - Kohei Okafuji
- Department of Pulmonary Medicine Thoracic Center, St. Luke's International Hospital Tokyo Japan
| | - Shosei Ro
- Department of Pulmonary Medicine Thoracic Center, St. Luke's International Hospital Tokyo Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine Thoracic Center, St. Luke's International Hospital Tokyo Japan
| | - Kasumi Shirasaki
- Emergency and Critical Care Medicine St. Luke's International Hospital Tokyo Japan
| | - Yu Watanabe
- Emergency and Critical Care Medicine St. Luke's International Hospital Tokyo Japan
| | - Naoki Nishimura
- Department of Pulmonary Medicine Thoracic Center, St. Luke's International Hospital Tokyo Japan
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17
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Yamada D, Ohde S, Imai R, Ikejima K, Matsusako M, Kurihara Y. Visual classification of three computed tomography lung patterns to predict prognosis of COVID-19: a retrospective study. BMC Pulm Med 2022; 22:1. [PMID: 34980061 PMCID: PMC8721943 DOI: 10.1186/s12890-021-01813-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/22/2021] [Indexed: 01/10/2023] Open
Abstract
Background Quantitative evaluation of radiographic images has been developed and suggested for the diagnosis of coronavirus disease 2019 (COVID-19). However, there are limited opportunities to use these image-based diagnostic indices in clinical practice. Our aim in this study was to evaluate the utility of a novel visually-based classification of pulmonary findings from computed tomography (CT) images of COVID-19 patients with the following three patterns defined: peripheral, multifocal, and diffuse findings of pneumonia. We also evaluated the prognostic value of this classification to predict the severity of COVID-19. Methods This was a single-center retrospective cohort study of patients hospitalized with COVID-19 between January 1st and September 30th, 2020, who presented with suspicious findings on CT lung images at admission (n = 69). We compared the association between the three predefined patterns (peripheral, multifocal, and diffuse), admission to the intensive care unit, tracheal intubation, and death. We tested quantitative CT analysis as an outcome predictor for COVID-19. Quantitative CT analysis was performed using a semi-automated method (Thoracic Volume Computer-Assisted Reading software, GE Health care, United States). Lungs were divided by Hounsfield unit intervals. Compromised lung (%CL) volume was the sum of poorly and non-aerated volumes (− 500, 100 HU). We collected patient clinical data, including demographic and clinical variables at the time of admission. Results Patients with a diffuse pattern were intubated more frequently and for a longer duration than patients with a peripheral or multifocal pattern. The following clinical variables were significantly different between the diffuse pattern and peripheral and multifocal groups: body temperature (p = 0.04), lymphocyte count (p = 0.01), neutrophil count (p = 0.02), c-reactive protein (p < 0.01), lactate dehydrogenase (p < 0.01), Krebs von den Lungen-6 antigen (p < 0.01), D-dimer (p < 0.01), and steroid (p = 0.01) and favipiravir (p = 0.03) administration. Conclusions Our simple visual assessment of CT images can predict the severity of illness, a resulting decrease in respiratory function, and the need for supplemental respiratory ventilation among patients with COVID-19.
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Affiliation(s)
- Daisuke Yamada
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
| | - Sachiko Ohde
- Graduate School of Public Health, St. Luke's International University, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Kengo Ikejima
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Masaki Matsusako
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Yasuyuki Kurihara
- Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
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18
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Enomoto Y, Imai R, Nanjo K, Fukai Y, Ishikawa K, Kotaki M. Comparison of the effects of three types of heating tobacco system and conventional cigarettes on indoor air quality. SN Appl Sci 2022. [DOI: 10.1007/s42452-021-04896-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Abstract
Environmental tobacco smoke (ETS) from conventional cigarettes is reported to affect indoor air quality (IAQ) in various real indoor environments. Recently, Japan Tobacco Inc. introduced three types of tobacco product that are heated rather than combusted. These comprise one direct heating tobacco system and two in-direct heating tobacco systems. In this study, the impact of using these products on IAQ was evaluated in an environmentally controlled chamber. Two environmental conditions, simulating restaurant and residential spaces, were examined. Under the same conditions, cigarette smoking and the presence of people only were used as positive and negative controls, respectively. The indoor air concentrations of 48 constituents (tobacco-specific nitrosamines, carbonyls, volatile organic compounds, total volatile organic compounds, polycyclic aromatic hydrocarbon, polycyclic aromatic amines, mercury, metals, ETS markers, propylene glycol, glycerol, carbon monoxide, carbon dioxide, suspended particle matter, ammonia, and nitrogen oxides) were measured. Compared with the presence of people, the concentrations of some constituents were actually increased when using heating tobacco products under both environmental conditions, simulating restaurant and residential spaces. However, the constituent concentrations were lower than those obtained by cigarette smoking, except for propylene glycol and glycerol, and below the exposure limits for constituents in air, as defined by air quality guidelines or regulations. Based on these data, the use of heating tobacco systems in appropriate indoor environments has less impacts compared to conventional cigarettes.
Article Highlights
We measured the indoor air concentrations of chemical constituents generated when using three heating tobacco systems with different heating mechanisms in two environment conditions simulating restaurant and residential spaces (positive control: when smoking cigarettes, negative control: the presence of people only).
In the measurement and analysis method used this study, it was possible to find not only that the air concentration generated when using the heating tobacco systems in this study were considerably lower than that when smoking cigarettes, but also the differences of the concentrations between heating tobacco systems with different heating mechanisms.
We showed some constituents which actually increased the air concentrations when using heating tobacco systems compared with the presence of people only.
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19
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Abe T, Yoshimua Y, Imai R, Sato Y. A Combined Assessment Method of Phase Angle and Skeletal Muscle Index to Better Predict Functional Recovery after Acute Stroke. J Nutr Health Aging 2022; 26:445-451. [PMID: 35587756 DOI: 10.1007/s12603-022-1777-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Indexed: 01/10/2023]
Abstract
OBJECTIVES We aimed to investigate whether combination assessment of phase angle (PhA) and skeletal muscle index (SMI), was a possible predictor of physical function at discharge from the hospital in patients with acute stroke. RESEARCH METHODS AND PROCEDURES In this retrospective cohort study that was conducted from May 2020 and July 2021, we determined PhA and SMI using bioimpedance analysis (BIA) in patients with acute stroke. Patients were classified as normal, low PhA + SMI group, pre-sarcopenia (low SMI only), and dynapenia (low PhA only) using cut-off points (men: SMI < 7.0 kg/m2, PhA < 4.05 degrees; women: SMI < 5.7 kg/m2, PhA < 3.55 degrees). The main outcome was physical function based on functional independence measure motor (FIM-motor) score at discharge. Multiple regression analysis was used to determine the association between low PhA + SMI and FIM-motor score. RESULTS We included 244 patients (161 men; mean age, 73.9 years). low PhA + SMI was found in 21 (8.6%) patients. Multiple regression analysis showed that low PhA + SMI was independently associated with the FIM-motor score at discharge (β= -0.099, 95%CI: -0.193,-0.005, p = 0.039). The PhA cutoff values for determining good functional results using receiver operating characteristic (ROC) curves were 5.36 for men (sensitivity = 0.769, specificity = 0.586, area under the curve [AUC] = 0.682), and 3.85 for women (sensitivity = It was 0.881, specificity = 0.481, AUC). Further, pearson correlation coefficient showed that PhA was significantly related to FIM-motor score in patients with mild or moderately severe stroke (mild: r = 0.472, p < 0.001; moderate: r = 0.524, p < 0.001). CONCLUSIONS Combination of low PhA and SMI values at baseline, was an independent predictor of physical function at discharge in patients with acute stroke. The findings highlighted the importance of measuring PhA and SMI using BIA in patients with acute stroke.
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Affiliation(s)
- T Abe
- Yoshihiro Yoshimura, Kumamoto Rehabilitation Hospital, Kikuchi, Kumamoto Japan,
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20
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Imai R, Mizuno A, Miyashita M, Okafuji K, Kitamura A, Tomishima Y, Jinta T, Nishimura N, Tamura T. Bereaved Family Members' Perceived Care at the End of Life for Patients with Noncancerous Respiratory Diseases. Palliat Med Rep 2021; 2:265-271. [PMID: 34927152 PMCID: PMC8675229 DOI: 10.1089/pmr.2021.0034] [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] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Data regarding the quality of end-of-life care for patients with noncancerous illnesses are lacking. Objective: This study aimed to evaluate end-of-life care for patients with noncancerous respiratory disease from the perspective of bereaved family members and explore the factors associated with the quality of patient death and care. Design: This cross-sectional study included patients who had died of noncancerous respiratory disease in general wards of pulmonary department in Japan between 2014 and 2016 and conducted an anonymous self-report questionnaire survey for the patients' bereaved family members. Measurements: We evaluated overall satisfaction with care and the quality of death and end-of-life care using the Good Death Inventory (GDI) and Care Evaluation Scale (CES), respectively. A multiple linear regression analysis was performed to explore the factors associated with these outcomes. Results: In total, 130 questionnaires were distributed, and the effective response rate was 38% and 50 patients were included (median age: 82 [range 58–101] years; 37 men [74%]). Primary diagnoses at death included 29 cases of pneumonia (58%), 15 interstitial lung disease (30%), and 3 chronic obstructive pulmonary disease (6%). Of the bereaved family members, 26 (52%) were spouses, and 19 (38%) were children (median age [range]: 68 [33–102] years, 15 men [30%]). The overall CES and GDI scores (mean ± standard deviation) were 77 ± 15 and 79 ± 15, respectively. The presence of dementia was an independent factor associated with high CES and GDI scores in the multiple linear regression analysis. Conclusions: In patients who died of noncancerous respiratory disease, the presence of dementia could be associated with the higher quality of patient death and care. In dementia, an understanding of the terminal nature of this condition may lead to an appropriate end-of-life care.
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Affiliation(s)
- Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Atsushi Mizuno
- Cardio Vascular Center, St. Luke's International Hospital, Tokyo, Japan
| | - Mitsunori Miyashita
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kohei Okafuji
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Atsushi Kitamura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Yutaka Tomishima
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Naoki Nishimura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Tomohide Tamura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
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21
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Terayama T, Taniguchi T, Imai R, Anan K, Yoshida T, Ando K, Okamori S, Okada Y. Protocol for a systematic review and meta-analysis of studies on the use of brain natriuretic peptide and N-terminal brain natriuretic peptide levels in the diagnosis of cardiopulmonary edema in acute respiratory failure. Syst Rev 2021; 10:314. [PMID: 34911558 PMCID: PMC8675464 DOI: 10.1186/s13643-021-01869-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dyspnea with bilateral pulmonary edema is common among patients in emergency departments (EDs) or intensive care units (ICUs). For the initial management of patients with this condition, cardiopulmonary edema (CPE) must be differentiated from acute respiratory distress syndrome (ARDS) in clinical settings. Brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NT-proBNP) are useful in distinguishing these conditions. However, current data about the use of these indexes are limited. Hence, we planned to perform a systematic review and meta-analysis to determine the accuracy of the two indexes for the diagnosis of CPE. METHODS We designed and registered a study protocol for a systematic review and meta-analysis. This study aims to determine the diagnostic accuracy of BNP and NT-proBNP based on the standards of the methodology of the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy and the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies in reporting the findings of this review. We will search PubMed (MEDLINE), Cochrane Library, Embase, www.ClinicalTrials.gov , International Clinical Trials Registry Platform, and Google Scholar. Randomized controlled trials, cross-sectional studies, and observational cohort studies reporting the accuracy in diagnosing CPE among adult patients with dyspnea and bilateral pulmonary edema will be included in the analysis. There will be no limits regarding language and publication date for this review. Two reviewers will independently screen articles, extract data, evaluate for quality and bias using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2), and use Grading of Recommendations Assessment, Development and Evaluation to summarize the strength of body of evidence. Then, a meta-analysis will be performed, and different statistical methods will be used to investigate heterogeneity among studies. A subgroup analysis of elderly patients with left ventricular dysfunction or chronic renal dysfunction will be performed. In the meta-analysis, a hierarchical summary receiver operating characteristic model or a bivariate model will be used in each index test, as appropriate. DISCUSSION A systematic review and meta-analysis of the accuracy of BNP and NT-proBNP for the diagnosis of CPE will be conducted. The result of this study can help clinicians to identify an appropriate initial treatment for patients with acute respiratory failure, including those with ARDS and CPE. To the best of our knowledge, this will be the first comprehensive systematic review focusing on ARDS management in a specific population. SYSTEMATIC REVIEW REGISTRATION PROSPERO ID CRD42020201576.
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Affiliation(s)
- Takero Terayama
- Department of Psychiatry, School of Medicine, National Defense Medical College, Saitama, Japan.
| | - Takuya Taniguchi
- Department of Cardiovascular Medicine, Otsu City Hospital, Otsu, Shiga, Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Keisuke Anan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takuo Yoshida
- Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Nishi-Shinbashi Minato-ku, Tokyo, Japan
| | - Koichi Ando
- Division of Allergology and Respiratory Medicine, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Satoshi Okamori
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yohei Okada
- Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Preventive Services, School of Public Health, Kyoto, Japan
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22
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Imai R, Nishimura N, Takahashi O, Tamura T. High-resolution computed tomography for the prediction of mortality in acute respiratory distress syndrome: A retrospective cohort study. Health Sci Rep 2021; 4:e418. [PMID: 34646945 PMCID: PMC8499594 DOI: 10.1002/hsr2.418] [Citation(s) in RCA: 2] [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: 06/01/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND AIMS Acute respiratory distress syndrome (ARDS) demonstrates several image patterns on high-resolution computed tomography (HRCT). The purpose of this study was to investigate the relationship between specific HRCT findings and the prognosis of ARDS. METHODS This was a retrospective cohort study performed in a single hospital in Japan. We categorized HRCT findings into three distribution patterns: diffuse, subpleural sparing, and dorsal patterns. All patterns were assessed at three levels of each lung. Multivariable logistic regression analysis was used to identify parameters associated with in-hospital mortality. RESULTS A total of 144 patients with ARDS (age: 72 ± 16 years, 112 men) were included in the study. The in-hospital mortality rate was 42% (survivors, n = 83; nonsurvivors, n = 61). Nonsurvivors were significantly older (70 ± 17 vs 76 ± 13, P = 0.01) and had lower serum albumin levels (P = 0.01), more traction bronchiectasis (P = 0.02), and more diffuse pattern (P < 0.001) than survivors. The presence of diffuse patterns was an independent adverse prognostic factor for predicting mortality (odds ratio, 1.32; 95% confidence interval [CI]: 1.08-1.61, P = 0.007). CONCLUSIONS HRCT distribution patterns may predict mortality in ARDS patients.
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Affiliation(s)
- Ryosuke Imai
- Department of Pulmonary MedicineThoracic Center, St. Luke's International HospitalTokyoJapan
| | - Naoki Nishimura
- Department of Pulmonary MedicineThoracic Center, St. Luke's International HospitalTokyoJapan
| | - Osamu Takahashi
- Graduate School of Public HealthSt. Luke's International UniversityTokyoJapan
| | - Tomohide Tamura
- Department of Pulmonary MedicineThoracic Center, St. Luke's International HospitalTokyoJapan
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23
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Rammitsu K, Kajita T, Imai R, Ogura-Tsujita Y. Strong primer bias for Tulasnellaceae fungi in metabarcoding: Specific primers improve the characterization of the mycorrhizal communities of epiphytic orchids. MYCOSCIENCE 2021; 62:356-363. [PMID: 37090180 PMCID: PMC9721509 DOI: 10.47371/mycosci.2021.06.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 01/25/2023]
Abstract
Primer bias toward Tulasnellaceae fungi during PCR is a known issue with metabarcoding analyses for the assessment of orchid mycorrhizal communities. However, this bias had not been evaluated for the fungal communities of epiphytic orchids, which account for 69% of all orchid species diversity. We compared the mycorrhizal communities detected using two primer pairs, a fungal universal primer pair (ITS86F/ITS4) and Tulasnella-specific primer pair (5.8STulngs/ITS4-Tul2), using a mock community of fungal isolates from epiphytic orchids and also environmental samples, including orchid roots and a tree bark tip from the host tree of an epiphytic orchid collected. The detected mycorrhizal communities differed widely depending on the primer pairs used. The fungal universal primer pair successfully identified Ceratobasidiaceae and Serendipitaceae fungi but did not reflect Tulasnellaceae diversity. Tulasnellaceae fungi were mainly detected using the Tulasnella-specific primer pair. These tendencies were observed in both the mock community and environmental samples. These results strongly suggest that the use of a Tulasnella-specific primer in combination with a fungal universal primer is essential for assessing the mycorrhizal communities of orchids through metabarcoding analysis, especially in epiphytic orchids. Our study contributes to further understanding of the diversity of mycorrhizal fungi in orchids.
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Affiliation(s)
| | - Tadashi Kajita
- The United Graduate School of Agricultural Sciences, Kagoshima University
| | - Ryosuke Imai
- Tropical Biosphere Research Center, University of the Ryukyus
| | - Yuki Ogura-Tsujita
- The United Graduate School of Agricultural Sciences, Kagoshima University
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24
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Komatsu J, Nishimura Y, Sugane H, Hosoda H, Imai R, Nakaoka Y, Nishida K, Seki S, Kubokawa S, Kawai K, Hamashige N, Doi Y. Acute circumflex coronary artery occlusion; dilemma in diagnosis and management. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Acute coronary syndrome (ACS) with occlusion of the circumflex coronary artery (LCX) poses diagnostic dilemma that may lead to a delay in reperfusion.
Purpose
We sought to assess the diagnostic significance of initial electrocardiography (ECG) changes in patients with acute LCX occlusion in relation to its clinical characteristics and the management.
Methods
From consecutive 1269 patients with ACS who were admitted to our institution during a 5-year period (2015–2019), 138 patients with ACS due to LCX occlusion were analyzed for clinical, ECG and angiographic presentation, and the door-to-balloon (DTB) time. ECG changes were classified into 4 different patterns: 1) ST-elevation in inferior/lateral leads (ST-E); 2) ST-depression in V1-V4 (ST-D); 3) no significant ST changes (No-ST); and 4) others.
Results
(1) No-ST pattern was found in 47 patients (34%), ST-E in 47 patients (34%), ST-D in 25 patients (18%) and others in 19 patients (14%). (2) Occlusion site: Proximal LCX; 16 patients with No-ST (34%), 6 patients with ST-E (13%), 13 patients with ST-D (52%). Distal LCX; 28 patients with No-ST (60%), 35 patients with ST-E (74%), 11 patients with ST-D (44%) (p=0.007). (Table) (3) Echocardiographic identification of left ventricular asynergy; 31 patients with No-ST (66%), 38 patients with ST-E (81%), 22 patients with ST-D (88%). (4) No-ST group was associated with longer DTB time; 245 min (170–562 min), compared to 93 min (83–121 min) in ST-E group and 97 min (70–129 min) in ST-D group (p<0.0001). DTB time ≤90 min was significantly uncommon in No-ST group (11%), compared to ST-E group (46%) and ST-D group (43%) (p=0.0004). (Figure)
Conclusion
One-third of the patients with LCX-ACS showed no ST changes, resulting in significantly longer DTB time. Improving diagnostic accuracy with anticipation for LCX-ACS and the use of echocardiographic examination and also the possible application of posterior leads (V7-V9) recording is challenging but critical to avoid delayed reperfusion and to improve outcomes in these patients without ECG changes.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Komatsu
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - Y Nishimura
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - H Sugane
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - H Hosoda
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - R Imai
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - Y Nakaoka
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - K Nishida
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - S Seki
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - S Kubokawa
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - K Kawai
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - N Hamashige
- Chikamori Hospital, Cardiology, Kochi, Japan
| | - Y Doi
- Chikamori Hospital, Cardiomyopathy Institute, Kochi, Japan
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25
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Shindo Y, Kondoh Y, Kada A, Doi Y, Tomii K, Mukae H, Murata N, Imai R, Okamoto M, Yamano Y, Miyazaki Y, Shinoda M, Aso H, Izumi S, Ishii H, Ito R, Saito AM, Saito TI, Hasegawa Y. Phase II Clinical Trial of Combination Therapy with Favipiravir and Methylprednisolone for COVID-19 with Non-Critical Respiratory Failure. Infect Dis Ther 2021; 10:2353-2369. [PMID: 34368914 PMCID: PMC8349598 DOI: 10.1007/s40121-021-00512-9] [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: 06/16/2021] [Accepted: 07/23/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction The administration of systemic corticosteroids is a key strategy for improving COVID-19 outcomes. However, evidence is lacking on combination therapies of antiviral agents and systemic corticosteroids. The objective of this study was to investigate the efficacy and safety of the combination therapy of favipiravir and methylprednisolone in preventing respiratory failure progression in patients with COVID-19 and non-critical respiratory failure. Methods We conducted a multicenter, open-label, single-arm phase II study. The patients received favipiravir 3600 mg on the first day, followed by 1600 mg for a total of 10–14 days. Methylprednisolone was administered intravenously at 1 mg/ideal body weight (IBW)/day from days 1 to 5, followed by 0.5 mg/IBW/day from days 6 to 10 if clinically indicated. The primary endpoint was the proportion of patients requiring mechanical ventilation (MV) (including noninvasive positive pressure ventilation) or those who met the criteria for tracheal intubation within 14 days of the study treatment initiation (MVCTI-14). Results Sixty-nine patients were enrolled and underwent the study treatment. Of them, the MVCTI-14 proportion was 29.2% (90% confidence interval 20.1–39.9, p = 0.200). The proportion of patients who required MV or who died within 30 days was 26.2%, and 30-day mortality was 4.9%. The most significant risk factor for MVCTI-14 was a smoking history (odds ratio 4.1, 95% confidence interval 1.2–14.2). The most common grade 3–4 treatment-related adverse event was hyperglycemia, which was observed in 21.7%. Conclusion The MVCTI-14 proportion did not reach a favorable level in the clinical trial setting with the threshold of 35%. However, the proportion of MV or death within 30 days was 26.6%, which might be close to the findings (28.1%) of the RECOVERY trial, which showed the efficacy of dexamethasone for patients with COVID-19 and non-critical respiratory failure. Further evaluation of this combination therapy is needed. Clinical Trial Registration Japan Registry of Clinical Trials (jRCT) identifier jRCTs041200025. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00512-9.
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Affiliation(s)
- Yuichiro Shindo
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan
| | - Akiko Kada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yohei Doi
- Department of Infectious Diseases, Fujita Health University School of Medicine, Toyoake, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Naohiko Murata
- Department of Respiratory Medicine, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Masaki Okamoto
- Department of Respirology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yasuhiko Yamano
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Shinoda
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Tokyo, Japan
| | - Hiromichi Aso
- Department of Respiratory Medicine, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruyuki Ishii
- Department of Respiratory Medicine, Kyorin University, Tokyo, Japan
| | - Ryota Ito
- Department of Infectious Diseases, Fujita Health University School of Medicine, Toyoake, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Toshiki I Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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26
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Imai R, Ro S, Tomishima Y, Nishimura N. Steroid resistance and rebound phenomena in patients with COVID-19. Respir Investig 2021; 59:608-613. [PMID: 34154977 PMCID: PMC8196332 DOI: 10.1016/j.resinv.2021.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/29/2021] [Accepted: 05/17/2021] [Indexed: 12/29/2022]
Abstract
Background In patients with coronavirus disease (COVID-19) pneumonia, corticosteroids reduce progression to respiratory failure and death. Some patients, however, remain unresponsive to this treatment, or experience a rebound after termination. Methods This retrospective cohort study included COVID-19 patients treated with systemic corticosteroids in a Japanese hospital between June 1, 2020, and January 17, 2021. Patients were categorized into three groups: success, rebound, and refractory, and clinical characteristics and outcomes were compared. Results A total of 319 COVID-19 patients were admitted to our hospital and 113 patients met inclusion criteria. The success group had 83 patients (73.5%), the rebound group had nine patients (8.0%), and the refractory group had 21 patients (18.6%). Compared with the success group, the rebound group received corticosteroids earlier, for a shorter duration, and stopped them sooner. The median time from symptom onset to rebound was 12 days. There was no rebound after 20 days. Compared with the success group, the hazard ratio for the number of days from corticosteroid onset to an improvement of two points on a seven-point ordinal scale was 0.29 (95% confidence interval [CI], 0.14–0.60, P < .001) for the rebound group versus 0.13 (95% CI, 0.07–0.25, P < .001) for the refractory group. Conclusions COVID-19 patients treated with corticosteroids were classified into three response groups: success, rebound, and refractory, between which recovery time and prognosis differed. It was found that corticosteroid administration may prevent rebound phenomena if administered at least two weeks from symptom onset.
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Affiliation(s)
- Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Shosei Ro
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Yutaka Tomishima
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo City, Tokyo, 104-8560, Japan
| | - Naoki Nishimura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
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27
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Ro S, Imai R, Kitamura A, Jinta T, Nishimura N. Ultrasonic humidifier lung as a mimic of COVID-19. Respirol Case Rep 2021; 9:e00761. [PMID: 33976890 PMCID: PMC8094045 DOI: 10.1002/rcr2.761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 01/19/2023] Open
Abstract
Chest computed tomography (CT) has been used to complement coronavirus disease 2019 (COVID-19) diagnosis due to its high sensitivity. However, owing to the low specificity of CT findings, differential diagnosis is essential. The typical CT findings of COVID-19 include ground-glass opacifications and consolidations with predominant distribution in bilateral, peripheral, and subpleural parts of the lung. These imaging findings are non-specific and may resemble other lung conditions, including ultrasonic humidifier lung, which is a condition that develops on inhaling aerosols generated by ultrasonic humidifiers. We present two patients with initial symptoms similar to COVID-19. CT examination revealed centrilobular nodules and consolidations with upper lobe-predominant distribution, although atypical for COVID-19, but key findings for ultrasonic humidifier lung. Therefore, ultrasonic humidifier lung could be a differential diagnosis for COVID-19 in dry environments. Characteristic CT findings and a history of ultrasonic humidifier use are critical to the final diagnosis.
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Affiliation(s)
- Shosei Ro
- Department of Pulmonary MedicineThoracic Center, St. Luke's International HospitalChuo‐kuJapan
| | - Ryosuke Imai
- Department of Pulmonary MedicineThoracic Center, St. Luke's International HospitalChuo‐kuJapan
| | - Atsushi Kitamura
- Department of Pulmonary MedicineThoracic Center, St. Luke's International HospitalChuo‐kuJapan
| | - Torahiko Jinta
- Department of Pulmonary MedicineThoracic Center, St. Luke's International HospitalChuo‐kuJapan
| | - Naoki Nishimura
- Department of Pulmonary MedicineThoracic Center, St. Luke's International HospitalChuo‐kuJapan
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28
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Kitamura A, Okafuji K, Imai R, Murakami M, Ro S, Tomishima Y, Jinta T, Nishimura N, Tamura T. Reproducibility of peripheral branches in virtual bronchoscopic navigation using VINCENT and LungPoint software for peripheral lung lesions. Respir Investig 2021; 59:772-776. [PMID: 33992600 DOI: 10.1016/j.resinv.2021.04.006] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/18/2021] [Accepted: 04/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Recently, virtual bronchoscopic navigation (VBN) has become frequently used for the pathological specimen collection of peripheral lung lesions using various VBN software packages. Herein, we examined the reproducibility of peripheral branches in VBN software using LungPoint and VINCENT versions 4.0 and 5.5. METHODS This study included patients suspected of malignant peripheral lung lesions who underwent bronchoscopy at our hospital from February 2016 to April 2017. Computed tomography was taken at a thickness of 1.25 mm in all cases, and VB images were created based on the computed tomography data using LungPoint, or VINCENT version 4.0 or 5.5. One observer read the program-generated VB images and compared how many branches could be visualized with the lobe bronchus as the primary branch. RESULTS A total of 129 patients (n = 131 lesions) underwent bronchoscopy, with 82 cases of primary lung cancer. Pathological bronchoscopic diagnosis was done in 63 cases, resulting to a diagnostic rate of 76.8%. VB images generated by LungPoint, and VINCENT versions 4.0 and 5.5 reproduced an average of 4.3, 3.47, and 5.12 branches, respectively, with significant differences (p < 0.05) between them. CONCLUSIONS VINCENT version 5.5 exhibits better reproducibility of peripheral branches than LungPoint for VBN.
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Affiliation(s)
- Atsushi Kitamura
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan.
| | - Kohei Okafuji
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Ryosuke Imai
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Manabu Murakami
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Shosei Ro
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Yutaka Tomishima
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Torahiko Jinta
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Naoki Nishimura
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Tomohide Tamura
- Department of Respiratory Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
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29
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Snyder RP, Guerin MT, Hargis BM, Imai R, Kruth PS, Page G, Rejman E, Barta JR. Exploiting digital droplet PCR and Next Generation Sequencing technologies to determine the relative abundance of individual Eimeria species in a DNA sample. Vet Parasitol 2021; 296:109443. [PMID: 34147767 DOI: 10.1016/j.vetpar.2021.109443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/24/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
DNA-based diagnostic assays for detecting infections with Eimeria species have been limited to providing identification and presence/absence data for samples containing oocysts. Modern technologies that generate quantitative data, such as droplet digital PCR (ddPCR) and Next Generation Sequencing (NGS), utilize a relatively short amplicon size containing sufficient species-specific variation for reliable species level identification. Targeting the cytochrome c oxidase subunit III gene in the mitochondrial genome, we established protocols using these technologies to determine the relative abundance of the number of copies/μL of Eimeria species in a sample. Samples from chickens of known and unknown Eimeria species composition were analyzed to determine the suitability of these technologies as diagnostic assays. All technologies demonstrated robust capability of identifying and quantifying the Eimeria species in samples. The new quantitative assays described herein will produce invaluable detail of Eimeria species infections for an array of situations in commercial chicken production systems, enabling further characterization of the disease profile and allowing for the development or enhancement of new intervention strategies.
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Affiliation(s)
- R P Snyder
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G 2W1, Canada.
| | - M T Guerin
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G 2W1, Canada
| | - B M Hargis
- Department of Poultry Science, University of Arkansas, 1260 W. Maple, Fayetteville, AR, 72703, USA
| | - R Imai
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G 2W1, Canada
| | - P S Kruth
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G 2W1, Canada
| | - G Page
- Trouw Nutrition R&D, Stationsstraat 77, Amersfoort, 3800 AG, The Netherlands
| | - E Rejman
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G 2W1, Canada
| | - J R Barta
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G 2W1, Canada
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30
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Sakaguchi S, Asaoka Y, Takahashi D, Isagi Y, Imai R, Nagano AJ, Qiu YX, Li P, Lu R, Setoguchi H. Inferring historical survivals of climate relicts: the effects of climate changes, geography, and population-specific factors on herbaceous hydrangeas. Heredity (Edinb) 2021; 126:615-629. [PMID: 33510468 PMCID: PMC8115046 DOI: 10.1038/s41437-020-00396-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/25/2020] [Accepted: 12/08/2020] [Indexed: 01/29/2023] Open
Abstract
Climate relicts hold considerable importance because they have resulted from numerous historical changes. However, there are major interspecific variations among the ways by which they survived climate changes. Therefore, investigating the factors and timing that affected population demographics can expand our understanding of how climate relicts responded to historical environmental changes. Here, we examined herbaceous hydrangeas of genus Deinanthe in East Asia, which show limited distributions and a remarkable disjunction between Japan and central China. Chloroplast genome and restriction site-associated DNA sequencing revealed that speciation event occurred in the late Miocene (ca. 7-9 Mya) in response to global climate change. Two lineages apparently remained not branched until the middle Quaternary, and afterwards started to diverge to regional population groups. The narrow endemic species in central China showed lower genetic diversity (He = 0.082), as its population size rapidly decreased during the Holocene due to isolation in montane refugia. Insular populations in the three Japanese islands (He = 0.137-0.160) showed a genetic structure that was inconsistent with sea barriers, indicating that it was shaped in the glacial period when its range retreated to coastal refugia on the exposed sea floor. Demographic modelling by stairway-plot analysis reconstructed variable responses of Japanese populations: some experienced glacial bottlenecks in refugial isolation, while post-glacial range expansion seemingly exerted founder effects on other populations. Overall, this study demonstrated the involvement of not just one, but multiple factors, such as the interplay between climate changes, geography, and other population-specific factors, that determine the demographics of climate relicts.
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Affiliation(s)
- Shota Sakaguchi
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, 606-8501, Japan.
| | - Yui Asaoka
- Faculty of Integrated Human Studies, Kyoto University, Kyoto, 606-8501, Japan
- Primate Research Institute, Kyoto University, Inuyama, Aichi, 484-8506, Japan
| | - Daiki Takahashi
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, 606-8501, Japan
| | - Yuji Isagi
- Division of Forest and Biomaterials Science, Graduate School of Agriculture, Kyoto University, Kyoto, 606-8502, Japan
| | - Ryosuke Imai
- Iriomote Station, Tropical Biosphere Research Centre, University of the Ryukyus, Okinawa, 907-1541, Japan
| | - Atsushi J Nagano
- Faculty of Agriculture, Ryukoku University, Shiga, 520-2194, Japan
| | - Ying-Xiong Qiu
- College of Life Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Pan Li
- College of Life Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Ruisen Lu
- College of Life Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Hiroaki Setoguchi
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, 606-8501, Japan
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31
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Imai R, Ikemura S, Jinta T. Anti-TIF1γ antibody-positive dermatomyositis associated with durvalumab administration in a patient with lung and oesophageal cancers. Respirol Case Rep 2021; 9:e00736. [PMID: 33777398 PMCID: PMC7985661 DOI: 10.1002/rcr2.736] [Citation(s) in RCA: 2] [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: 01/19/2021] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 11/09/2022] Open
Abstract
We report a case of anti-transcriptional intermediary factor 1γ (TIF1γ) antibody-positive dermatomyositis following durvalumab treatment. The patient was successfully treated with pulse steroid therapy, high-dose intravenous immunoglobulin (IVIg), and tacrolimus. Durvalumab may induce dermatomyositis, and early diagnosis and aggressive therapy are crucial to prevent severe dermatomyositis, which is potentially treatable.
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Affiliation(s)
- Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Sumie Ikemura
- Department of DermatologySt. Luke's International HospitalTokyoJapan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
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32
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Imai R, Tsuda Y, Ebihara A, Matsumoto S, Tezuka A, Nagano AJ, Ootsuki R, Watano Y. Mating system evolution and genetic structure of diploid sexual populations of Cyrtomium falcatum in Japan. Sci Rep 2021; 11:3124. [PMID: 33542454 PMCID: PMC7862634 DOI: 10.1038/s41598-021-82731-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 01/12/2021] [Indexed: 11/09/2022] Open
Abstract
Evolution of mating systems has become one of the most important research areas in evolutionary biology. Cyrtomium falcatum is a homosporous fern species native to eastern Asia. Two subspecies belonging to a sexual diploid race of C. falcatum are recognized: subsp. littorale and subsp. australe. Subspecies littorale shows intermediate selfing rates, while subsp. australe is an obligate outcrosser. We aimed to evaluate the process of mating system evolution and divergence for the two subspecies using restriction site associated DNA sequencing (RAD-seq). The results showed that subsp. littorale had lower genetic diversity and stronger genetic drift than subsp. australe. Fluctuations in the effective population size over time were evaluated by extended Bayesian skyline plot and Stairway plot analyses, both of which revealed a severe population bottleneck about 20,000 years ago in subsp. littorale. This bottleneck and the subsequent range expansion after the LGM appear to have played an important role in the divergence of the two subspecies and the evolution of selfing in subsp. littorale. These results shed new light on the relationship between mating system evolution and past demographic change in fern species.
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Affiliation(s)
- Ryosuke Imai
- Sugadaira Research Station, Mountain Science Center, University of Tsukuba, Sugadaira, Ueda , Nagano, 386-2204, Japan.
| | - Yoshiaki Tsuda
- Sugadaira Research Station, Mountain Science Center, University of Tsukuba, Sugadaira, Ueda , Nagano, 386-2204, Japan
| | - Atsushi Ebihara
- Department of Botany, National Museum of Nature and Science, Tsukuba, Ibaraki, 305-0005, Japan
| | - Sadamu Matsumoto
- Department of Botany, National Museum of Nature and Science, Tsukuba, Ibaraki, 305-0005, Japan
| | - Ayumi Tezuka
- Faculty of Agriculture, Ryukoku University, Otsu, Shiga, 520-2194, Japan
| | - Atsushi J Nagano
- Faculty of Agriculture, Ryukoku University, Otsu, Shiga, 520-2194, Japan
| | - Ryo Ootsuki
- Department of Natural Sciences, Faculty of Arts and Sciences, Komazawa University, 1-23-1 Komazawa, Setagaya-ku, Tokyo, 154-8525, Japan
| | - Yasuyuki Watano
- Department of Biology, Graduate School of Science, Chiba University, Inage, Chiba, Chiba, 263-8522, Japan
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Abstract
We assembled a complete chloroplast genome of a pantropical legume, Canavalia rosea (Fabaceae). The chloroplast genome was 158,059 bp in length that was composed of a 77,752 bp large single copy region, a 18,993 bp small single copy region, and a pair of 30,657 bp inverted repeats. We detected 135 genes that consisted of 90 protein-coding genes, 37 tRNA genes, eight rRNA genes, and three pseudogenes (rps16 and a pair of rpl22).
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Affiliation(s)
- Ryosuke Imai
- Iriomote Station, Tropical Biosphere Research Center, University of the Ryukyus, Okinawa, Japan
| | - Yui Kajita
- Iriomote Station, Tropical Biosphere Research Center, University of the Ryukyus, Okinawa, Japan
| | - Takashi Yamamoto
- Hijirigaoka High & Junior High School, Tama University, Tokyo, Japan
| | - Koji Takayama
- Department of Botany, Graduate School of Science, Kyoto University, Kyoto, Japan
| | - Tadashi Kajita
- Iriomote Station, Tropical Biosphere Research Center, University of the Ryukyus, Okinawa, Japan
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34
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Ro S, Nishimura N, Imai R, Tomishima Y, So C, Murakami M, Okafuji K, Kitamura A, Jinta T, Tamura T. Identification of patients with COVID-19 who are optimal for methylprednisolone pulse therapy. Multidiscip Respir Med 2021; 16:781. [PMID: 34322232 PMCID: PMC8273631 DOI: 10.4081/mrm.2021.781] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Corticosteroids have been reported to reduce the mortality rates in patients with coronavirus disease 2019 (COVID-19). Additionally, the role of high-dose methylprednisolone pulse therapy in reducing mortality in critically ill patients has also been documented. The purpose of this study is to identify patients with COVID-19 who are suitable for methylprednisolone pulse therapy. METHODS This was a retrospective study that included patients with COVID-19 receiving methylprednisolone pulse therapy (≥250 mg/day for 3 days) with subsequent tapering doses at our hospital between June 2020 and January 2021. We examined the differences in background clinical factors between the surviving group and the deceased group. RESULTS Out of 156 patients who received steroid therapy, 17 received methylprednisolone pulse therapy. Ten patients recovered (surviving group) and seven patients died (deceased group). The median age of the surviving and deceased groups was 64.5 years (range, 57-85) and 79 years (73-90), respectively, with a significant difference (p=0.004). Five of the deceased patients (71%) had developed serious complications associated with the cause of death, including pneumothorax, pneumomediastinum, COVID-19-associated pulmonary aspergillosis, cytomegalovirus infection, and bacteremia. On the other hand, out of the 10 survivors, only one elderly person had cytomegalovirus infection and the rest recovered without complications. CONCLUSION Administration of methylprednisolone pulse therapy with subsequent tapering may be an effective treatment in patients with COVID-19 up to the age of early 70s; however, severe complications may be seen in elderly patients.
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Affiliation(s)
| | - Naoki Nishimura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560 Japan. Tel. +81.3.3541-5151.
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35
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Nakano Y, Okumura N, Imai R, Yoshida M, Shimokata S, Adachi S, Murohara T, Kondo T. Impact of higher detection rate of residual pulmonary thromboemboli one-year after acute pulmonary embolism: modified CT scan imaging method with modified CT obstruction index. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recently, post pulmonary embolism (PE) syndrome or chronic thromboembolic disease after acute PE, has been recognized as important long-term complications. Furthermore, patients may develop with chronic thromboembolic pulmonary hypertension.
Purpose
We aimed to evaluate the frequency of residual pulmonary thromboemboli after acute PE by using our “higher”-resolution CT scan imaging method to detect residual thromboemboli down to sub-segmental pulmonary arteries.
Methods
This study was a prospective multi-center observational study. We enrolled consecutive 34 patients with acute symptomatic PE whose informed consent was obtained, and followed up for one year. One year after the onset of acute PE, patients were referred to our hospital and multiple examination including CT scan, 6-minute walk test (6MWT), questionnaire of SF-36, echocardiography and laboratory testing were performed. Additionally, we have modified the CT obstruction index (CTOI) to quantitatively evaluate the thromboemboli down to sub-segmental pulmonary arteries.
Results
Mean age was 60.5±15.8 years, and 56% were male. No patient was categorized as low recurrent VTE risk which was caused by transient factors, one patient was associated with active cancer, and 12% had known thrombophilia. In 85% of the patients, this onset was the first obvious episode of PE. At diagnosis, elevated B-type natriuretic peptide (BNP) (≥100 pg/ml) or N-terminal (NT)-proBNP (≥500 pg/ml) was observed in 45% of the patients. Median tricuspid regurgitation peak gradient (TRPG) by echocardiography was 30.9 (19.3–50.1) mmHg. Among all, 35% of the patients received single-drug approach with DOACs. At discharge, all of the patients except two were treated with DOACs.
One year after the onset, 21% of the patient were in NYHA II and others were in NYHA I. It was notable that pulmonary thromboemboli was detected by our CT scan in 76% of the patients. Modified CTOI was median 11.9 (1.8–24.4) % as shown in the figure.
In multiple regression analysis, TRPG at diagnosis and BNP at one month were significantly associated with mCTOI (β=0.536, p=0.002 and β=−0.482, p=0.003, respectively). Additionally, lowest SpO2 during 6MWT after one year from the onset, tended to inversely associate with mCTOI (β=−0.341, p=0.052).
Conclusions
Using our modified CT scan imaging method and modified CTOI, residual pulmonary thromboemboli was able to be detected more frequently than the previous studies. Residual pulmonary thromboemboli could be one of the cause of the post PE syndrome and lead to exercise-induced desaturation.
Figures
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Nakano
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
| | - N Okumura
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - R Imai
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - M Yoshida
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Shimokata
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Adachi
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kondo
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
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Nakano Y, Imai R, Yoshida M, Shimokata S, Adachi S, Murohara T, Kondo T. Clinical course of pulmonary embolism patients treated with DOACs: comparing prognosis, recurrent thromboembolism, and major bleeding between patients with and without cancer. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Venous thromboembolism (VTE) is the third frequent acute cardiovascular syndrome in the Europe and Japan. Since direct oral anticoagulants (DOACs) are widely used now, the morbidity and mortality of pulmonary embolism (PE) patients especially associated with cancer needs to be re-evaluated.
Purpose
We evaluated the clinical course of patients with PE mainly treated with DOACs.
Methods
This retrospective observational study was conducted in a single center. The data were collected from the medical record of consecutive patients who received inpatient treatment of PE. In this study, we have compared PE patients with cancer (cancer PE) to those without cancer (non-cancer PE) and evaluated the mortality, recurrent of VTE and major bleedings.
Results
In total, 140 patients were enrolled: 94 patients were cancer-related, and 46 patients were without cancer (Table). The type of the tumor in cancer PE patients were as follows: gastric 8 (9%), esophageal 5 (5%), pancreatic 12 (13%), lung 14 (15%), lymphoma 2 (2%), gynecologic 17 (18%), renal 2 (2%), bile duct 8 (9%), colon 12 (13%), and others 17 (18%).
Kaplan-Meier curve showed that the cumulative all-cause mortality was significantly higher in the cancer PE group (35/94 (37%) vs. 2/46 (4%), P<0.001 (log rank), HR 10.3 [95% CI:2.5–43.3]). The cumulative incidence of recurrent VTE was significantly higher in the cancer PE group (7/94 (7%) vs. 0/46, P=0.03 (log rank)). There was no significant difference in the cumulative incidence of major bleeding between the cancer PE group and the non-cancer PE group (8/94 (9%) vs. 5/46 (11%)).
Conclusions
The risk of recurrent VTE was still higher in cancer PE patients compared to non-cancer PE patients, although DOACs were used. Meanwhile the incidence of major bleeding was comparable in both groups, the risk of bleeding might be acceptable with using DOACs especially in cancer PE patients.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Nakano
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
| | - R Imai
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - M Yoshida
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Shimokata
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Adachi
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kondo
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
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37
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Affiliation(s)
- S Ro
- From the Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - R Imai
- From the Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - T Tamura
- From the Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
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Ide S, Imai R, Ochi H, Maeshima K. Transcriptional suppression of ribosomal DNA with phase separation. Sci Adv 2020; 6:6/42/eabb5953. [PMID: 33055158 PMCID: PMC7556839 DOI: 10.1126/sciadv.abb5953] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 08/25/2020] [Indexed: 05/21/2023]
Abstract
The nucleolus is a nuclear body with multiphase liquid droplets for ribosomal RNA (rRNA) transcription. How rRNA transcription is regulated in the droplets remains unclear. Here, using single-molecule tracking of RNA polymerase I (Pol I) and chromatin-bound upstream binding factor (UBF), we reveal suppression of transcription with phase separation. For transcription, active Pol I formed small clusters/condensates that constrained rDNA chromatin in the nucleolus fibrillar center (FC). Treatment with a transcription inhibitor induced Pol I to dissociate from rDNA chromatin and to move like a liquid within the nucleolar cap that transformed from the FC. Expression of a Pol I mutant associated with a craniofacial disorder inhibited transcription by competing with wild-type Pol I clusters and transforming the FC into the nucleolar cap. The cap droplet excluded an initiation factor, ensuring robust silencing. Our findings suggest a mechanism of rRNA transcription suppression via phase separation of intranucleolar molecules governed by Pol I.
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Affiliation(s)
- Satoru Ide
- Genome Dynamics Laboratory, National Institute of Genetics, Mishima, Shizuoka 411-8540, Japan.
- Department of Genetics, Sokendai (Graduate University for Advanced Studies), Shizuoka 411-8540, Japan
| | - Ryosuke Imai
- Genome Dynamics Laboratory, National Institute of Genetics, Mishima, Shizuoka 411-8540, Japan
- Department of Genetics, Sokendai (Graduate University for Advanced Studies), Shizuoka 411-8540, Japan
| | - Hiroko Ochi
- Genome Dynamics Laboratory, National Institute of Genetics, Mishima, Shizuoka 411-8540, Japan
| | - Kazuhiro Maeshima
- Genome Dynamics Laboratory, National Institute of Genetics, Mishima, Shizuoka 411-8540, Japan.
- Department of Genetics, Sokendai (Graduate University for Advanced Studies), Shizuoka 411-8540, Japan
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39
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Kadota N, Murakami M, Imai R, Jinta T, Tamura T. Unilateral pleural effusion with capillary haemangioma. Respirol Case Rep 2020; 8:e00613. [PMID: 32607245 PMCID: PMC7317172 DOI: 10.1002/rcr2.613] [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: 05/07/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 11/20/2022] Open
Abstract
Here, we report a case of haemangioma on middle mediastinum accompanied by unilateral pleural effusion, which was initially suspected to be lung cancer and pleurisy. During annual check-up, chest radiography of a 30-year-old female showed homogeneous opacity in the left lower pulmonary field. Excision was performed, and the mass was pathologically diagnosed as benign mediastinal vascular tumour with exudative pleural effusion. To our knowledge, this presentation occurs in <0.5% of tumours of the mediastinum, and furthermore, the presence of pleural fluid is extremely rare, and the underlying mechanism is unknown. Although mediastinal haemangioma is hard to diagnose without surgery, we should include it in the differential diagnosis of a tumour with unilateral pleural effusion.
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Affiliation(s)
- Nozomi Kadota
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyo104‐8560Japan
| | - Manabu Murakami
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyo104‐8560Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyo104‐8560Japan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyo104‐8560Japan
| | - Tomohide Tamura
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyo104‐8560Japan
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40
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Hibino Y, Imai R, Jinta T. Diffuse large B-cell lymphoma presenting with cavitary lung disease. Respirol Case Rep 2020; 8:e00584. [PMID: 32405417 PMCID: PMC7214784 DOI: 10.1002/rcr2.584] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 11/11/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) with cavitary lung disease is rare and is often difficult to differentiate from primary lung cancer, granulomatous disease, or an infectious disease based on imaging findings alone. We herein report a case in which a patient with DLBCL presented with cavitary lung disease and splenic mass, which was diagnosed by transbronchial biopsy. DLBCL should be considered as a differential diagnosis in patients with cavitary lung diseases who have rare metastatic lesions for primary lung cancer, such as intra-abdominal lymph nodes or spleen.
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Affiliation(s)
- Yukiko Hibino
- Department of Internal MedicineSt. Luke's International HospitalTokyoJapan
| | - Ryosuke Imai
- Department of Pulmonary MedicineSt. Luke's International Hospital, Thoracic CenterTokyoJapan
| | - Torahiko Jinta
- Department of Pulmonary MedicineSt. Luke's International Hospital, Thoracic CenterTokyoJapan
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41
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So C, Ro S, Murakami M, Imai R, Jinta T. High-dose, short-term corticosteroids for ARDS caused by COVID-19: a case series. Respirol Case Rep 2020; 8:e00596. [PMID: 32514354 PMCID: PMC7273438 DOI: 10.1002/rcr2.596] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/17/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023] Open
Abstract
We report a case series of seven mechanically ventilated patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID‐19) who received early treatment with high‐dose, short‐term systemic corticosteroids to prevent cytokine overproduction. Of the seven patients, four were male and median age was 69 years. They were intubated within seven days after admission when their respiratory status rapidly worsened. At that time, we administered 1000 or 500 mg/day for three days of methylprednisolone intravenously, followed by 1 mg/kg and tapered off. The median duration for the total administration of corticosteroids was 13 days. This high‐dose, short‐term corticosteroid therapy enabled extubation of the patients within seven days. Many questions on the clinical management of COVID‐19 remain unanswered, and data on corticosteroid therapy as a choice of treatment are mixed. We present the clinical course of our cases, review the previous evidence, and discuss management.
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Affiliation(s)
- Clara So
- Department of Pulmonary Medicine, Thoracic Center St. Luke's International Hospital Tokyo Japan
| | - Shosei Ro
- Department of Pulmonary Medicine, Thoracic Center St. Luke's International Hospital Tokyo Japan
| | - Manabu Murakami
- Department of Pulmonary Medicine, Thoracic Center St. Luke's International Hospital Tokyo Japan
| | - Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic Center St. Luke's International Hospital Tokyo Japan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, Thoracic Center St. Luke's International Hospital Tokyo Japan
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42
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Imai R, Tomishima Y. Left ventricular dysfunction in an idiopathic pulmonary fibrosis patient on nintedanib. Respirol Case Rep 2020; 8:e00533. [PMID: 32082576 PMCID: PMC7017142 DOI: 10.1002/rcr2.533] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 11/30/2022] Open
Abstract
Nintedanib, a tyrosine kinase inhibitor, is approved for the treatment of idiopathic pulmonary fibrosis. We report a case of left ventricular dysfunction in a patient with idiopathic pulmonary fibrosis treated with nintedanib, which recovered after cessation of nintedanib. Nintedanib may induce left ventricular dysfunction, and early recognition is important since this condition is potentially reversible.
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Affiliation(s)
- Ryosuke Imai
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
| | - Yutaka Tomishima
- Department of Pulmonary Medicine, Thoracic CenterSt. Luke's International HospitalTokyoJapan
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43
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Yamakawa U, Kaneko S, Imai R, Faulks LK, Kon K, Kyogoku D, Isagi Y, Tsuda Y. Development of microsatellite markers for the endangered sleeper Eleotris oxycephala (Perciformes: Eleotridae). Genes Genet Syst 2019; 94:219-224. [PMID: 31735739 DOI: 10.1266/ggs.19-00007] [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] [Indexed: 11/23/2022] Open
Abstract
The amphidromous sleeper Eleotris oxycephala (Perciformes: Eleotridae) is mainly distributed along the Kuroshio Current in East Asia, and this current is thought to be the main driver of the species' dispersal. Due to anthropogenic environmental changes in rivers, E. oxycephala is ranked as a threatened or near-threatened species in the red lists of 12 prefectures in Japan. Moreover, there is concern that the species' dispersal pattern could be changed due to fluctuations in the Kuroshio Current caused by global warming. In this study, 40 microsatellite markers were developed for E. oxycephala, and their suitability was tested on 43 individuals from two populations of E. oxycephala from Kanagawa and Miyazaki Prefectures. The number of alleles, expected heterozygosity and fixation index at each locus were 2-10 (mean = 5.350), 0.034-0.860 (mean = 0.650) and -0.261-0.448 (mean = 0.065), respectively. Furthermore, there was a lack of genetic difference between the two populations (FST = 0.008, F'ST = 0.024), indicating widespread gene flow via the Kuroshio Current. These markers will be useful to evaluate the genetic structure and infer population demographic history of E. oxycephala populations, which may assist in the conservation of this species.
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Affiliation(s)
- Uchu Yamakawa
- Sugadaira Research Station, Mountain Research Center, University of Tsukuba
| | - Shingo Kaneko
- Faculty of Symbiotic Systems Science, Fukushima University
| | - Ryosuke Imai
- Sugadaira Research Station, Mountain Research Center, University of Tsukuba
| | - Leanne Kay Faulks
- Sugadaira Research Station, Mountain Research Center, University of Tsukuba
| | - Koetsu Kon
- Shimoda Marine Research Center, University of Tsukuba
| | | | - Yuji Isagi
- Graduate School of Agriculture, Kyoto University
| | - Yoshiaki Tsuda
- Sugadaira Research Station, Mountain Research Center, University of Tsukuba
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44
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Kitamura A, Okafuji K, Imai R, Kanemura H, Tsugitomi R, Tomishima Y, Jinta T, Nishimura N, Tamura T. Comparison of accuracy of VBN (virtual bronchoscopic navigation) software (VINCENT vs. LungPoint) for peripheral lung lesions and trial of prediction of diagnostic yield from VBN findings. Lung Cancer 2019. [DOI: 10.1183/13993003.congress-2019.oa1906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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45
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Abstract
We documented four cases of systemic lupus erythematosus (SLE) presenting with pleuritis as the initial disease manifestation. The diagnosis was challenging because, atypically, all patients were elderly and 3 of the 4 patients were men. Furthermore, SLE pleuritis, characterized by lymphocytic pleural effusion and high ADA activity, is difficult to differentiate from tuberculous pleurisy. A detailed physical examination, blood tests, and urinalysis are therefore indispensable to ensure an accurate diagnosis. We also reviewed the previously published case reports on SLE patients presenting with pleuritis and discussed the relevant findings.
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Affiliation(s)
- Clara So
- Internal Medicine, St. Luke's International Hospital, Japan
| | - Ryosuke Imai
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan
| | - Yutaka Tomishima
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan
| | - Naoki Nishimura
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan
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46
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Nagashima R, Hibino K, Ashwin SS, Babokhov M, Fujishiro S, Imai R, Nozaki T, Tamura S, Tani T, Kimura H, Shribak M, Kanemaki MT, Sasai M, Maeshima K. Single nucleosome imaging reveals loose genome chromatin networks via active RNA polymerase II. J Cell Biol 2019; 218:1511-1530. [PMID: 30824489 PMCID: PMC6504897 DOI: 10.1083/jcb.201811090] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/31/2019] [Accepted: 02/07/2019] [Indexed: 01/01/2023] Open
Abstract
When a gene is activated, chromatin in the transcribed region is thought to be more open and dynamic. However, Nagashima et al. found that this is not necessarily the case—inhibition of transcription globally increases chromatin motion, revealing the existence of loose genome chromatin networks via transcriptional machinery. Although chromatin organization and dynamics play a critical role in gene transcription, how they interplay remains unclear. To approach this issue, we investigated genome-wide chromatin behavior under various transcriptional conditions in living human cells using single-nucleosome imaging. While transcription by RNA polymerase II (RNAPII) is generally thought to need more open and dynamic chromatin, surprisingly, we found that active RNAPII globally constrains chromatin movements. RNAPII inhibition or its rapid depletion released the chromatin constraints and increased chromatin dynamics. Perturbation experiments of P-TEFb clusters, which are associated with active RNAPII, had similar results. Furthermore, chromatin mobility also increased in resting G0 cells and UV-irradiated cells, which are transcriptionally less active. Our results demonstrated that chromatin is globally stabilized by loose connections through active RNAPII, which is compatible with models of classical transcription factories or liquid droplet formation of transcription-related factors. Together with our computational modeling, we propose the existence of loose chromatin domain networks for various intra-/interchromosomal contacts via active RNAPII clusters/droplets.
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Affiliation(s)
- Ryosuke Nagashima
- Genome Dynamics Laboratory, National Institute of Genetics, Research Organization of Information and Systems, Mishima, Japan.,Department of Genetics, School of Life Science, SOKENDAI, Mishima, Japan
| | - Kayo Hibino
- Genome Dynamics Laboratory, National Institute of Genetics, Research Organization of Information and Systems, Mishima, Japan.,Department of Genetics, School of Life Science, SOKENDAI, Mishima, Japan
| | - S S Ashwin
- Department of Applied Physics, Nagoya University, Nagoya, Japan.,Department of Computational Science and Engineering, Nagoya University, Nagoya, Japan
| | - Michael Babokhov
- Genome Dynamics Laboratory, National Institute of Genetics, Research Organization of Information and Systems, Mishima, Japan
| | - Shin Fujishiro
- Department of Applied Physics, Nagoya University, Nagoya, Japan.,Department of Computational Science and Engineering, Nagoya University, Nagoya, Japan
| | - Ryosuke Imai
- Genome Dynamics Laboratory, National Institute of Genetics, Research Organization of Information and Systems, Mishima, Japan.,Department of Genetics, School of Life Science, SOKENDAI, Mishima, Japan
| | - Tadasu Nozaki
- Genome Dynamics Laboratory, National Institute of Genetics, Research Organization of Information and Systems, Mishima, Japan
| | - Sachiko Tamura
- Genome Dynamics Laboratory, National Institute of Genetics, Research Organization of Information and Systems, Mishima, Japan
| | - Tomomi Tani
- Eugene Bell Center for Regenerative Biology and Tissue Engineering, Marine Biological Laboratory, Woods Hole, MA
| | - Hiroshi Kimura
- Cell Biology Center, Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Japan
| | - Michael Shribak
- Eugene Bell Center for Regenerative Biology and Tissue Engineering, Marine Biological Laboratory, Woods Hole, MA
| | - Masato T Kanemaki
- Department of Genetics, School of Life Science, SOKENDAI, Mishima, Japan.,Molecular Cell Engineering Laboratory, National Institute of Genetics, ROIS, Mishima, Japan
| | - Masaki Sasai
- Department of Applied Physics, Nagoya University, Nagoya, Japan.,Department of Computational Science and Engineering, Nagoya University, Nagoya, Japan
| | - Kazuhiro Maeshima
- Genome Dynamics Laboratory, National Institute of Genetics, Research Organization of Information and Systems, Mishima, Japan .,Department of Genetics, School of Life Science, SOKENDAI, Mishima, Japan
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47
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Imai R, Nakatani R, Nakaoka H, Tomishima Y, Jinta T, Chonabayashi N, Tamura T. Yellow Nail Syndrome Patients with Diffuse Panbronchiolitis-like Pulmonary Manifestation. Intern Med 2019; 58:553-556. [PMID: 30210127 PMCID: PMC6421143 DOI: 10.2169/internalmedicine.1466-18] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/19/2018] [Indexed: 11/30/2022] Open
Abstract
Yellow nail syndrome (YNS) is a rare clinical syndrome characterized by a triad of yellow thick nail, lymphedema and respiratory diseases. We experienced 2 cases of YNS with diffuse panbronchiolitis (DPB)-like pulmonary manifestation. Since YNS might be hidden to those who have been diagnosed with DPB, physicians should be alert to recognize nail signs of YNS in case of DPB refractory to macrolide therapy. We hereby review previous case reports of YNS and discuss its pulmonary manifestations.
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Affiliation(s)
- Ryosuke Imai
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan
| | - Ryo Nakatani
- Internal Medicine, St. Luke's International Hospital, Japan
| | - Hiroshi Nakaoka
- Department of Respiratory Medicine, Chikamori Hospital, Japan
| | - Yutaka Tomishima
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan
| | - Torahiko Jinta
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan
| | - Naohiko Chonabayashi
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan
| | - Tomohide Tamura
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan
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48
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Imai R, Ono M, Nishimura N, Suzuki K, Komiyama N, Tamura T. Fulminant Myocarditis Caused by an Immune Checkpoint Inhibitor: A Case Report With Pathologic Findings. J Thorac Oncol 2019; 14:e36-e38. [DOI: 10.1016/j.jtho.2018.10.156] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 11/30/2022]
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49
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Affiliation(s)
- R Imai
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - T Jinta
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
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50
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Kitamura A, Okafuji K, Imai R, Kanemura H, Ishii K, Tsugitomi R, Tomishima Y, Jinta T, Nishimura N, Tamura T. Comparison of abilities of virtual bronchoscopic navigation (VBN) software products to reproduce peripheral branches in diagnosing peripheral lung lesions. Imaging 2018. [DOI: 10.1183/13993003.congress-2018.oa5172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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