Publications by authors named "Iwanaga N"

Objective: The global prevalence of nontuberculous mycobacterial pulmonary disease (NTM-PD) has been steadily increasing. A few small retrospective studies have reported a poor prognosis associated with chronic pulmonary aspergillosis (CPA) as a complication of NTM-PD. Furthermore, the prognostic impact of CPA may have been inadequately assessed due to differences in background factors.

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Introduction: Despite the ongoing efforts to refine treatment durations and methods for patients with chronic pulmonary aspergillosis, the clinical use of antifungal agents remains unclear. This study aimed to describe the treatment practices, trajectories, and prognoses of newly diagnosed patients with chronic pulmonary aspergillosis.

Methods: Data from a longitudinal database from hospitals in Japan was used.

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is an emerging pathogenic fungus that is highly resistant to existing antifungal drugs. Manogepix is a novel antifungal agent that exerts antifungal activity by inhibiting glycosylphosphatidylinositol anchor biosynthesis. Although the mechanisms of resistance of species to manogepix have been reported previously, those of are yet to be studied.

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Background: Although pancreaticoduodenectomy (PD) for pancreatic or periampullary cancer is the gold standard treatment regardless of patient age, patients aged 80 years or older have poor postoperative short-term outcomes because of their poor functional status and many medical comorbidities. Postoperative rehabilitation in octogenarians could improve postoperative outcomes; however, its effect remains unclear.

Methods: This retrospective study included patients who underwent PD at two institutions between January 2019 and December 2022.

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Exophiala dermatitidis is an emerging black fungus that causes pulmonary infections that may be underestimated by conventional culture methods. We encountered one case that initially appeared to be yeast and was misidentified as Rhodotorula spp. using a commercial identification kit.

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Article Synopsis
  • - The study investigates how periodontal pathogens cause severe inflammation by examining the role of neutrophils and the potential treatment effects of macrolides like clarithromycin on this inflammation.
  • - Researchers tested clarithromycin on human airway epithelial cells exposed to pathogen supernatants, finding it reduced the production of the inflammatory marker IL-8 by interfering with specific signaling pathways.
  • - Results suggest that the extracellular signal-regulated kinases (ERK) are activated by pathogen exposure and that clarithromycin pretreatment can inhibit this activation, pointing to its therapeutic potential for managing inflammation caused by periodontal pathogens in lung tissues.
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Introduction: The diagnostic tools of nucleic acid amplification tests and antigen tests have been extensively employed for the detection of Coronavirus disease 2019 (COVID-19). Although the reverse-transcriptase polymerase chain reaction (RT)-PCR test has high sensitivity and specificity, it is a time-consuming and labor-intensive process. On the other hand, antigen tests are simple and prompt, however, their low sensitivity and potential for false positives have been identified as limitations.

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This retrospective cohort study analyzed data from a Japanese health insurance database to assess the effectiveness of baloxavir (n = 4822) for preventing severe events compared with oseltamivir (n = 10,523) in patients with influenza B. The primary endpoint was hospitalization incidence (Days 2-14). The secondary endpoints included intravenous antibacterial drug use, pneumonia hospitalization, heart failure hospitalization, inhalational oxygen requirement, and use of other anti-influenza drugs.

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Introduction: This study aimed to evaluate the effectiveness of ensitrelvir, an oral antiviral, in reducing hospitalization risk in outpatients at high-risk for severe COVID-19 during the Omicron era.

Methods: This was a retrospective study using a large Japanese health insurance claims database. It included high-risk outpatients for severe symptoms who received their first COVID-19 diagnosis between November 2022 and July 2023.

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Background: Chlorhexidine gluconate solution is superior to povidone-iodine for prevention of surgical site infection. However, the overall efficacy of chlorhexidine gluconate for surgical site infection prevention in various types of gastroenterological surgery, as well as the optimal concentration of chlorhexidine gluconate, remain unclear. The aim of the present study was to clarify whether subcutaneous wound soaking with chlorhexidine gluconate would reduce the incidence of surgical site infection associated with gastroenterological surgery in patients with wound classes Ⅱ to Ⅳ.

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Metal-organic frameworks (MOFs) are widely used for gas adsorption, separation, and sensing materials. In most cases, MOFs are not used in their crystal form but as impregnated materials because the fine crystals result in high-pressure drops. One key characteristic of MOF-impregnated materials is the amount of MOF in the material.

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Article Synopsis
  • - A middle-aged Japanese man with no known immunocompromised conditions developed a severe infection (fungemia) after undergoing surgery for ileal diverticulitis, caused by a newly recognized ascomycetous yeast pathogen.
  • - Initial treatment with micafungin was ineffective, prompting a switch to a combination of liposomal amphotericin B and caspofungin, which ultimately cleared the infection.
  • - Despite the presence of septic emboli in the lungs and spleen, the patient showed no signs of heart infection after extensive testing, and he remained symptom-free after receiving prolonged antifungal therapy.
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Background And Objective: The identification of factors associated with long-term prognosis after community-onset pneumonia in elderly patients should be considered when initiating advance care planning (ACP). We aimed to identify these factors and develop a prediction score model.

Methods: Patients aged 65 years and older, who were hospitalized for pneumonia at nine collaborating institutions, were included.

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Purpose: Despite the importance of abscess lesions in clinical decisions regarding anaerobic bacteremia (AB), their impact on clinical characteristics remains unclear. Herein, we aimed to elucidate the clinical factors associated with AB that were unaccompanied by detectable abscess lesions during the initial phase of infection.

Methods: This was a multicenter retrospective observational study involving patients with culture-proven AB at six tertiary hospitals in Japan between January 2012 and March 2022.

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Background: The aim of this study was to evaluate the effectiveness of a modified reconstruction technique-anchored straight stomach reconstruction-in reducing the incidence of delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD) and its impact on postoperative nutritional recovery.

Methods: A case series analysis of 125 consecutive PD patients was conducted: 104 of them had undergone anchored straight stomach reconstruction (SSR group) and the remaining 21 without (Non-SSR group). The incidence of DGE and the change in postoperative nutritional status (body weight and serum albumin level during 12 months post-surgery) were compared.

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Lung tissue resident memory (TRM) cells are thought to play crucial roles in lung host defense. We have recently shown that immunization with the adjuvant LTA1 (derived from the A1 domain of E. coli heat labile toxin) admixed with OmpX from K.

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T cell immunity, including CD4+ and CD8+ T cell immunity, is critical to host immune responses to infection. Transcriptomic analyses of both CD4+ and CD8+ T cells of C57BL/6 mice show high expression the gene encoding embigin, Emb, which encodes a transmembrane glycoprotein. Moreover, we found that lung CD4+ Th17 tissue-resident memory T cells of C57BL/6 mice also express high levels of Emb.

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Article Synopsis
  • Invasive aspergillosis (IA) and mucormycosis are severe infections predominantly affecting immunocompromised individuals, and drug-resistant strains present a significant clinical challenge.* -
  • This research explores the potential of Vγ9Vδ2 T cells, a unique subset of T cells, in fighting these infections, showing strong antifungal properties against resistant strains by direct interaction with fungal hyphae.* -
  • The study highlights the promising role of Vγ9Vδ2 T cells as a new therapy for treating IA and mucormycosis, which could offer an effective alternative to traditional antifungal treatments that often have harmful side effects.*
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  • * Out of 672 patients analyzed, only 9 (1.3%) developed complicated NTM infections, leading to a higher mortality rate in those patients compared to others.
  • * The findings suggest that while NTM complications are rare among those on biologics, they can be severe, especially in patients taking higher doses of corticosteroids, necessitating vigilant monitoring even in the absence of positive MAC antibody tests.
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Background: Nursing- and healthcare-associated pneumonia (NHCAP) constitutes most of the pneumonia in elderly patients including aspiration pneumonia in Japan. Lascufloxacin (LSFX) possesses broad antibacterial activity against respiratory pathogens, such as Streptococcus spp. And anaerobes inside the oral cavity.

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Purpose: During the last decade, the incidence of anaerobic bacteremia (AB) has been increasing. Patients with AB may develop complex underlying diseases, which can occasionally be accompanied by fatal or fulminant outcomes. However, the risk factors for AB-related mortality remain unclear.

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Primary gallbladder neuroendocrine tumor (GB-NET) is extremely rare. Therefore, tumor behavior and adequate treatment in GB-NETs are still unclear. A 74-year-old man without any specific complaints was referred to our hospital cause of gallbladder tumor.

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Article Synopsis
  • Allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA) are related diseases caused by Aspergillus infection, with CPA sometimes developing from ABPA.
  • A case study reported on a patient experiencing both conditions concurrently and monitored serum cytokine levels at various stages of treatment.
  • The study found that IL-13 levels decreased with glucocorticoid treatment, while IL-25 and IL-33 levels dropped quickly after starting antifungal medications, suggesting early antifungal treatment is crucial for managing disease progression and preventing overlap of CPA.
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