Publications by authors named "Hirofumi Chiba"

A 71-year-old man with silicosis was treated for infection. Antimycobacterial treatment for was terminated 1 year after a negative test result for the bacteria on sputum examination. One year following the treatment, the patient developed pneumonitis.

View Article and Find Full Text PDF
Article Synopsis
  • * A case study of a 44-year-old male with advanced non-small cell lung cancer (NSCLC) demonstrates the challenges of managing complications from ICI treatment, including serious side effects and COVID-19 infections that affected his treatment outcomes.
  • * While facing significant health issues, the patient experienced unexpected tumor regression and resolution of complications, suggesting that COVID-19 could potentially have beneficial antitumor effects, leading to new considerations for cancer treatment strategies.
View Article and Find Full Text PDF
Article Synopsis
  • The study explores the effectiveness of multidisciplinary discussions (MDD) among medical professionals for diagnosing interstitial lung diseases (ILDs) and aims to improve diagnostic accuracy, especially for idiopathic pulmonary fibrosis (IPF).
  • It utilizes a nationwide ILD registry in Japan to facilitate rapid MDD diagnoses and develop a modified diagnostic ontology, addressing issues of unclassifiable ILDs and potential new disease entities.
  • The research focuses on providing accurate diagnoses and treatment recommendations, evaluating ILD prevalence, and clarifying reasons for diagnostic challenges through a central online platform for expert collaboration.
View Article and Find Full Text PDF
Article Synopsis
  • Clinical amyopathic dermatomyositis is a skin condition that lacks muscle symptoms and is often associated with anti-melanoma differentiation-associated gene 5 antibodies, particularly in Japanese patients, leading to poor outcomes in those with lung complications.
  • A 52-year-old male presented with severe respiratory issues and skin rashes, diagnosed with dermatomyositis-related interstitial pneumonia, but treatment with steroids and immunosuppressants was largely ineffective.
  • Despite some initial improvement after switching medications, the patient ultimately faced worsening respiratory failure due to invasive pulmonary aspergillosis, resulting in a fatal outcome.
View Article and Find Full Text PDF

Background: Lung cancer is often diagnosed at an advanced stage; however, it has shown improved therapeutic efficacy with the introduction of molecularly targeted drugs and immune checkpoint inhibitors, necessitating accurate molecular diagnosis for effective treatment planning. Traditional sampling techniques, including endobronchial ultrasound-guided transbronchial needle aspiration, frequently require multiple biopsies to obtain sufficient tissues for multiplex testing, highlighting the need for more efficient methods. Therefore, we explored the diagnostic utility of endoscopic ultrasound with bronchoscope-guided fine-needle biopsy (EUS-B-FNB) versus fine-needle aspiration (EUS-B-FNA) in patients with lung cancer, focusing on tissue sample collection for molecular testing.

View Article and Find Full Text PDF
Article Synopsis
  • Radial incision and cutting (RIC) is explored as a new method for treating lower intestinal tract stenosis, aiming for high success rates and symptom relief, but patients often experience re-stenosis after the procedure.
  • In a pilot study involving 20 patients, RIC was performed with the addition of triamcinolone acetonide (TA), and the safety and efficacy were assessed after two months, focusing on adverse events and symptom improvement.
  • Results showed a delayed bleeding rate of 23.8%, but no perforations occurred; while symptoms improved, TA didn’t seem to significantly prevent re-stenosis, suggesting the need for further research.
View Article and Find Full Text PDF

Negative-pressure pulmonary edema (NPPE) arises from excessive inspiratory effort due to upper airway obstruction, often associated with postoperative laryngospasm and upper airway infections like epiglottitis. We present a case of NPPE during bronchoscopy. A 45-year-old female patient, who was undergoing bronchoscopy for interstitial pneumonia evaluation, was examined using a tracheal tube with a 7.

View Article and Find Full Text PDF

Background: In recent years, the incorporation of LAMAs into asthma therapy has been expected to enhance symptom control. However, a significant number of patients with asthma continue to experience poorly managed symptoms. There have been limited investigations on LAMA-induced airway alterations in asthma treatment employing IOS.

View Article and Find Full Text PDF

Idiopathic pulmonary fibrosis (IPF) is the archetypal interstitial lung disease. It is a chronic progressive condition that is challenging to manage as the clinical course of the disease is often difficult to predict. The prevalence of IPF is rising globally and in Japan, where it is estimated to affect 27 individuals per 100,000 of the population.

View Article and Find Full Text PDF

Background: The efficacy of anti-CTLA-4 antibody (ipilimumab) plus anti-programmed cell death 1 antibody (nivolumab) in treating advanced non-small cell lung cancer (NSCLC) is impeded by an elevated risk of severe immune-related adverse events. However, our understanding of associations among pre-existing fibrosis, emphysematous changes, and objective indicators as predictive factors is limited for severe pneumonitis in NSCLC patients receiving this combination therapy. Thus, we retrospectively investigated these associations, including overall tumor burden, before treatment initiation in the Japanese population.

View Article and Find Full Text PDF

Allergic bronchopulmonary aspergillosis (ABPA) often necessitates treatment with systemic steroids and antifungals, which are associated with relapses and side effects. We report an 82-year-old woman with eosinophilic asthma, experiencing sputum production and dyspnea, who was diagnosed with ABPA based on her chest CT, pulmonary function tests, and elevated blood eosinophils and immunoglobulin E. Due to the presence of osteoporosis and diabetes, standard steroid therapy was considered a high risk.

View Article and Find Full Text PDF
Article Synopsis
  • This study assessed the effectiveness of NUDT15 codon 139 genotyping to improve thiopurine treatment for inflammatory bowel disease (IBD) among 4628 patients in Japan.
  • Retrospective analysis showed that while genotyping did not significantly change thiopurine induction rates, it led to customized dosing that reduced adverse events (AEs) and improved treatment retention.
  • Findings indicated that starting doses and genotype-based adjustments can minimize risks, with specific genotypes correlating to different reactions to thiopurine treatments—providing a basis for more tailored treatment strategies.
View Article and Find Full Text PDF
Article Synopsis
  • - The study focuses on a new treatment method called radial incision and cutting (RIC) for lower gastrointestinal tract stenosis, which has advantages over traditional treatments like surgery and endoscopic balloon dilation (EBD), but still faces issues with restenosis.
  • - Researchers are conducting a phase II trial involving 20 participants aged 20-80, comparing the safety of administering triamcinolone acetonide (TA) post-RIC, assessing both the safety and effectiveness of this approach.
  • - Key outcomes include monitoring adverse events, the technical success of the RIC procedure, improvements in symptoms, and length of hospital stay, with the goal of providing data that could inform future studies on this treatment.
View Article and Find Full Text PDF

Purpose: Although immune checkpoint inhibitors (ICIs), together with cytotoxic chemotherapy (chemoimmunotherapy), have been adapted for the initial treatment of extensive-disease small-cell lung cancer (ED-SCLC), they have achieved limited success. In ED-SCLC, a subtype of SCLC, the expression of immune-related molecules and clinical data are not well understood in relation to ICI treatment efficiency.

Methods: We examined lung biopsy specimens from patients diagnosed with ED-SCLC treated with chemoimmunotherapy or chemotherapy.

View Article and Find Full Text PDF

The sputum colour in patients with severe pneumonia needs to be considered during diagnosis.

View Article and Find Full Text PDF

Humoral immunity is vital for host protection, yet aberrant antibody responses can trigger harmful inflammation and immune-related disorders. T follicular helper (Tfh) cells, central to humoral immunity, have garnered significant attention for unraveling immune mechanisms. This study shows the role of B-cell Oct-binding protein 1 (Bob1), a transcriptional coactivator, in Tfh cell regulation.

View Article and Find Full Text PDF

Objectives: To investigate the effectiveness of BMAX, a deep learning-based computer-aided detection system for detecting fibrosing interstitial lung disease (ILD) on chest radiographs among non-expert and expert physicians in the real-world clinical setting.

Design: Retrospective, observational study.

Setting: This study used chest radiograph images consecutively taken in three medical facilities with various degrees of referral.

View Article and Find Full Text PDF

Skeletal muscle metastasis of lung cancer is rare. However, clinicians should be aware that tumour-induced nerve compression symptoms may develop.

View Article and Find Full Text PDF

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disease with a poor prognosis. Pulmonary function tests (PFTs) aid in evaluating the disease status of IPF. The clinical significance of oscillometry measurements in interstitial lung diseases has recently been reported.

View Article and Find Full Text PDF

The relationships between T follicular helper (Tfh) cells and antigen-specific immunoglobulins (sIgs) in patients with allergic respiratory diseases who are receiving antigen immunotherapy (AIT) have not been fully clarified. Therefore, we started to perform house dust mite sublingual immunotherapy (HDM-SLIT) for 20 patients with atopic asthma comorbid with allergic rhinitis (AA+AR) who were already receiving ordinary treatments including inhaled corticosteroid (ICS). We examined percentages of circulating T follicular helper (cTfh) and regulatory (cTfr) cells and percentages of circulating regulatory T (cTreg) and B (cBreg) cells by FACS and we examined levels of sIgs by ELISA.

View Article and Find Full Text PDF

Gastrointestinal pseudo-obstruction (GIPO) is a phenotype of the paraneoplastic neurological syndrome (PNS). We herein report a case of small-cell lung carcinoma (SCLC) with GIPO elicited by an immune checkpoint inhibitor (ICI). A 75-year-old man with SCLC developed intractable intestinal obstruction after receiving one course of anticancer drugs (durvalumab, etoposide, and carboplatin).

View Article and Find Full Text PDF

Background: Transbronchial biopsy using an ultrathin bronchoscope (UTB) has a high diagnostic yield for peripheral pulmonary lesions (PPLs). When combined with peripheral transbronchial needle aspiration (pTBNA), it improves the diagnostic yield of "adjacent to" radial endobronchial ultrasonography (rEBUS) findings. However, pTBNA is a complicated technique, and the specimen volume is often inadequate for diagnostic and multiplex analyses.

View Article and Find Full Text PDF

Background: Amrubicin (AMR) regimens have shown efficacy as second-line treatment in patients with small cell lung cancer (SCLC); however, adverse events such as febrile neutropenia (FN) sometimes preclude their use. Further, the safety and efficacy of AMR with primary prophylactic pegfilgrastim (P-PEG) have not been sufficiently evaluated. In this study, we evaluated the safety and efficacy of AMR with or without P-PEG as second-line chemotherapy for SCLC.

View Article and Find Full Text PDF