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| 1.
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Furugen, Makoto ; Shibahara, Daisuke ; Kiyuna, Tomo ; Kami, Wakaki ; Miyagi, Kazuya ; Haranaga, Shusaku ; Kubota, Toru ; Matsumoto, Hirofumi ; Yoshimi, Naoki ; Fujita, Jiro
概要:
Pemetrexed has significant efficacy for some non-squamous non-small cell lung cancer cases, as demonstrated in the current case. For those patients, pemetrexed administration should be carefully considered.
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| 2.
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Nakamura, Hideta ; Miyagi, Kazuya ; Otsuki, Mariko ; Higure, Yuuri ; Nishiyama, Naoya ; Kinjo, Takeshi ; Nakamatsu, Masashi ; Haranaga, Shusaku ; Tateyama, Masao ; Fujita, Jiro
概要:
Treatment with tocilizumab (TCZ) to block interleukin-6 (IL-6) signalling is predicted to mitigate cytokine release synd
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rome (CRS) caused by coronavirus disease 2019 (COVID-19). However, the adverse effects of TCZ on patients with COVID-19 remain unclear. We herein report a patient with COVID-19 treated with TCZ who developed acute hypertriglyceridaemia. Despite favipiravir treatment, acute respiratory distress syndrome developed in a 45-year-old patient with COVID-19; thus, TCZ was initiated. The triglyceride levels greatly increased after TCZ administration. Physicians should consider the negative impact of TCZ on the lipid profile in patients with COVID-19, although COVID-19-induced CRS itself may be an aggravating factor.
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| 3.
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Nakamura, Hideta ; Tateyama, Masao ; Tasato, Daisuke ; Haranaga, Shusaku ; Higa, Futoshi ; Matsuzaki, Akiko ; Yoshimi, Naoki ; Fujita, Jiro
概要:
Asymptomatic pulmonary sarcoidosis can develop after starting antiretroviral therapy. The decision on whether to treat sarcoidosis with corticosteroids should be based on the disease severity.
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| 4.
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Yamauchi, Momoko ; Kinjo, Takeshi ; Parrott, Gretchen ; Miyagi, Kazuya ; Haranaga, Shusaku ; Nakayama, Yuko ; Chibana, Kenji ; Fujita, Kaori ; Nakamoto, Atsushi ; Higa, Futoshi ; Owan, Isoko ; Yonemoto, Koji ; Fujita, Jiro
概要:
Serum markers that differentiate between tuberculous and non-tuberculous pneumonia would be clinically useful. However,
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few serum markers have been investigated for their association with either disease. In this study, serum levels of interferon gamma (IFN-γ), matrix metalloproteinases 1 and 9 (MMP-1 and MMP-9, respectively), and periostin were compared between 40 pulmonary tuberculosis (PTB) and 28 non-tuberculous pneumonia (non-PTB) patients. Diagnostic performance was assessed by analysis of receiver-operating characteristic (ROC) curves and classification trees. Serum IFN-γ and MMP-1 levels were significantly higher and serum MMP-9 levels significantly lower in PTB than in non- PTB patients (p < 0.001, p = 0.002, p < 0.001, respectively). No significant difference was observed in serum periostin levels between groups. ROC curve analysis could not determine the appropriate cut-off value with high sensitivity and specificity; therefore, a classification tree method was applied. This method identified patients with limited infiltration into three groups with statistical significance (p = 0.01), and those with MMP-1 levels < 0.01 ng/ mL and periostin levels ≥ 118.8 ng/mL included only non-PTB patients (95% confidence interval 0.0–41.0). Patients with extensive infiltration were also divided into three groups with statistical significance (p < 0.001), and those with MMP-9 levels < 3.009 ng/mL included only PTB patients (95% confidence interval 76.8–100.0). In conclusion, the novel classification tree developed using MMP-1, MMP-9, and periostin data distinguished PTB from non- PTB patients. Further studies are needed to validate our cut-off values and the overall clinical usefulness of these markers.
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| 5.
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Kami-Onaga, Kaoru ; Tateyama, Masao ; Kinjo, Takeshi ; Parrott, Gretchen ; Tominaga, Daisuke ; Takahashi-Nakazato, Ai ; Nakamura, Hideta ; Tasato, Daisuke ; Miyagi, Kyoko ; Maeda, Saori ; Arae, Hirotaka ; Uehara, Hitoshi ; Miyagi, Kazuya ; Haranaga, Shusaku ; Fujita, Jiro
概要:
In this study, we demonstrated the pervasiveness of HIV-associated neurocognitive disorders (HAND) among a selection of
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Japanese patients as well as evaluated and comparedthe Mini Mental State Examination (MMSE) and the International HIV Dementia Scale(IHDS) for use as a screening tool among combination anti-retroviral therapy (cART)-naïveand cART experienced patients. The MMSE and the IHDS have both been used as HANDscreening tests around the world with variable success. It has been reported the increasedusage of cART the utility of these screening tests may have been diminished due to thedecreased severity of impairment and the altered pattern of neurocognitive impairments incART era HAND patients. It is therefore possible the MMSE and the IHDS may still be usefulamong cART-naïve patients even in the cART era. However, only one study has investigated and compared the screening results of the IHDS among cART-naïve and cART experienced patients. All HIV positive patients who visited, or were admitted, to the RyukyuUniversity Hospital between January 2009 and March 2014 were evaluated for inclusion.Selected patients (n = 49) had data without omission for all tests. The overall prevalence ofHAND in our cohort was 44%. The area under the curve (AUC), for all subjects using theMMSE and the IHDS, were 0.60 and 0.69, respectively. However, the AUC among cARTnaïve patients were 0.58 and 0.76 for the MMSE and the IHDS, respectively. Whereas,cART experienced patients had an AUC of 0.60 and 0.61, respectively. Overall, the MMSEdemonstrated a poor screening ability for HAND, regardless of cART usage (the cut-offvalue of 27 had a Youden’s J-Index of 0.1, in all groups). Alternatively, the IHDS was moderately useful for HAND screening among cART-naïve patients (the cut-off value of 11 had aYouden’s J-Index of 0.4), but performed poorly as a screening test among cART experienced patients (the cut-off value of 11 had a Youden’s J-Index of 0.1).
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| 6.
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Maruyama, Tessho ; Saio, Masanao ; Arasaki, Akira ; Nakasone, Toshiyuki ; Teruya, Takao ; Haranaga, Shusaku ; Nimura, Fumikazu ; Kawano, Toshihiro ; Matayoshi, Akira ; Yoshimi, Naoki ; Kuniyoshi, Yukio ; Fujita, Jiro ; Nishihara, Kazuhide
概要:
Sarcoidosis is a systemic, chronic inflammatory disease with unknown cause and is characterized by formation of epitheli
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oid granulomas in various organs, mainly the lungs and lymphatic system as mediastinal lymph nodes (LNs). Lymphadenopathy is common in sarcoidosis. Subsequent cancer also tends to occur in patients with the disease, and the most frequent is lymphoma and cancer of the lung. Head and neck cancer is uncommon but possible. We report a 70-year-old woman with squamous cell carcinoma (SCC) of the mandibular gingiva concomitant with mediastinal multiple lymphadenopathy, and a medical history of chronic sarcoidosis. Mediastinal LNs showed increased uptake of 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) with positron emission tomography (PET). Subsequent to lymphadenectomy, the histological diagnosis was lymphadenopathy caused by sarcoidosis. Next, we performed wide local excision of the gingival tumor. During follow-up, a pulmonary lesion was detected by computed tomography at 3 years and 11 months after surgery, and diagnosed as pulmonary sarcoidosis, which had been stable without treatment until now. After follow-up of 5 years, the patient was alive without signs of local recurrence or metastasis. The combination of oral SCC and sarcoidosis of the mediastinal LNs in a sarcoidosis patient has not been previously reported. FDG-PET was not able to distinguish LN metastasis from lymphadenopathy caused by sarcoidosis. In our case, her chronic inflammatory condition with sarcoidosis as well as ill-fitting dentures could have increased the risk of oral cancer. We suggest that clinicians should carefully check for the development of subsequent oral cancer in patients with a past history of sarcoidosis. To avoid inaccurate staging and incorrect therapy, LN biopsy should be promptly performed following a diagnosis of cancer and multiple lymphadenopathies in patients with a history of sarcoidosis. Lymphadenopathy with sarcoidosis patients have malignant potential, especially those who develop subsequent cancer. Misdiagnosis of LN malignancy and sarcoidosis may lead to unnecessary adjuvant therapy or worse prognosis.
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| 7.
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Shibahara, Daisuke ; Kinjo, Takeshi ; Nishiyama, Naoya ; Kami, Wakaki ; Nabeya, Daijiro ; Haranaga, Shusaku ; Higa, Futoshi ; Tateyama, Masao ; Shinzato, Takashi ; Toma, Hiromu ; Kishimoto, Hidehiro ; Fujita, Jiro
概要:
A 65-year-old man, who recently returned from Liberia, visited a clinic complaining of fever, and azithromycin was presc
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ribed. The patient presented to a general hospital 5 days after the onset of symptoms, however, a blood smear examination failed to detect malaria. Contrary to the blood smear result, a rapid antigen test in our hospital was strongly-positive for falciparum malaria, indicating a high level of malarial antigen in the blood. Moreover, laboratory examinations on admission showed a tendency for improvement. We assumed that the administration of azithromycin partially treated malaria, thus complicating the blood smear diagnosis. We should be careful in prescribing azithromycin, which is widely used in clinics, to travelers returning from malaria-endemic countries.
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| 8.
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Tamaki, Yuichiro ; Higa, Futoshi ; Tasato, Daisuke ; Nakamura, Hideta ; Uechi, Kayoko ; Tamayose, Maki ; Haranaga, Shusaku ; Yara, Satomi ; Tateyama, Masao ; Fujita, Jiro
概要:
Acute lung injury during pregnancy results in morbidity and mortality in both the mother and the fetus. Pneumocystis jir
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ovecii pneumonia (PCP) is a rare disease but may occur in pregnant immune-suppressed women. Here, we describe a case of acute lung injury due to PCP and alveolar hemorrhage in a pregnant woman who was a human T lymphotropic virus type-1 (HTLV-1) carrier. PCP should be considered in the differential diagnosis of pulmonary complications during pregnancy in HTLV-1 endemic areas.
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| 9.
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Furugen, Makoto ; Yamashiro, Shin ; Tamayose, Maki ; Naha, Yui ; Miyagi, Kazuya ; Nakasone, Chikara ; Uchihara, Teruhito ; Haranaga, Shusaku ; Azuma, Masato ; Yara, Satomi ; Takashi, Shinzato ; Higa, Futoshi ; Toma, Hiromu ; Tateyama, Masao ; Fujita, Jiro
概要:
A 42-year-old man was admitted to our hospital with a history of fever, headache and disorientation. His cerebrospinal f
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luid revealed eosinophilia and his serum had an antibody against Angiostrongylus cantonensis (A. cantonensis). Then, he was diagnosed as eosinophilic meningoencephalitis caused by A. cantonensis. He was treated with repeated lumbar punctures and oral prednisolone. Although a symptom he had been suffering from at the time of his admission was urinary retention, this symptom disappeared as his general condition improved. Therefore his case was considered to be Elsberg syndrome with eosinophilic meningoencephalitis caused by A. cantonensis.
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