Publications by authors named "Kenichiro Hara"

Background: Autoimmune pulmonary alveolar proteinosis (APAP) is a diffuse lung disease that causes abnormal accumulation of lipoproteins in the alveoli; however, its pathogenesis remains unclear. Recently, APAP cases have been reported during the course of dermatomyositis. The combination of these two diseases may be coincidental; however, it may have been overlooked because differentiating APAP from a flare-up of interstitial pneumonia associated with dermatomyositis is challenging.

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  • * The study reviewed 188 SSc patients, focusing on their esophageal function and treatments, finding that approximately 16% had medication-refractory RE despite being on acid-reducing treatments like PPIs and vonoprazan (VPZ).
  • * Key risk factors for medication-refractory RE included the number of esophagogastroduodenoscopies performed and the absence of esophageal contractility, with particularly severe cases linked to high grades of gastroesophageal flap
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  • Eosinophilic granulomatosis with polyangiitis (EGPA) is a type of systemic vasculitis that damages small to medium-sized blood vessels and can harm various organs due to high eosinophil levels.
  • Recent treatment guidelines for active non-severe EGPA have included the use of the anti-interleukin-5 antibody mepolizumab, but its effectiveness for severe cases isn't clearly established.
  • In a case study, a patient with EGPA and a serious complication (small intestine perforation) was treated successfully with steroids, immunoglobulin therapy, and mepolizumab, leading to remission, suggesting mepolizumab could be beneficial for severe EGPA cases.
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Introduction: Patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and idiopathic interstitial lung diseases (IIPs) are positive for myeloperoxidase (MPO)-ANCA. MPO-ANCA-positive vasculitis mainly comprises microscopic polyangiitis (MPA) and unclassifiable vasculitis. These diseases are frequently complicated by interstitial lung disease (ILD).

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Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors are standard therapeutic agents for non-small cell lung cancer (NSCLC) patients with major EGFR mutations such as exon 19 deletions and a L858R mutation, whereas treatment strategies for cases with uncommon EGFR mutations remain to be fully established. Here, we report a long-term (≥20 years from initial diagnosis) NSCLC survivor carrying EGFR L858R and L747V mutations. The patient received gefitinib monotherapy, systemic chemotherapy/chemoimmunotherapy, and local consolidative therapies for oligometastatic lesions, and responded to afatinib rechallenge with a progression-free survival of 12 months.

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  • Obesity is linked to worse outcomes in patients with anti-ARS antibody-related interstitial lung disease (ILD), as it affects lung function and increases disease relapse rates.
  • A study involving 58 patients found that obese individuals had lower lung diffusing capacity and higher fat deposits compared to nonobese patients.
  • The research highlights the importance of measuring chest fat using CT scans to predict ILD relapses, particularly noting that higher levels of certain fat types correlate with increased disease severity.
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Introduction: This study aimed to assess the utility of quantitative high-resolution computed tomography (HRCT) for determining the clinical course of anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis-associated interstitial lung disease (MDA5 ILD).

Method: This study retrospectively analyzed the data of 34 patients with MDA5 ILD to determine the association between the clinical findings and extent of ILD via quantitative CT analysis at baseline and short-term follow-up. Quantified HRCT scores were evaluated as the lung severity score (LSS), percentage of opacity, and percentage of high opacity.

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Coronavirus disease 2019 (COVID-19) has become a global pandemic since its discovery in December 2019, and as the disease continues to evolve, varying complications associated with it continue to arise. In this regard, computed tomography has played an extremely important role in the diagnosis and evaluation of COVID-19 pneumonia and its complications. We encountered a case of a male patient with neurofibromatosis (type I) who developed concurrent pneumothorax and pleural effusion during his recovery period from severe COVID-19 pneumonia.

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Anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV) occurs in elderly people, and patients with anti-myeloperoxidase autoantibodies (MPO-ANCA)-positive AAV are often complicated with interstitial lung disease (ILD). This study aimed to evaluate the age-related clinical features of elderly patients with MPO-ANCA-positive AAV-ILD. This study retrospectively investigated 63 patients with MPO-ANCA-positive AAV-ILD, all of whom were 65 years or older at diagnosis.

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  • Recent studies suggest afatinib is effective for non-small cell lung cancer (NSCLC) patients with rare EGFR mutations, but its long-term effectiveness through rechallenge is still under investigation.
  • This report features a case where a patient with dual EGFR mutations (G719C and S768I) had a significant survival outcome after receiving afatinib again followed by chemotherapy.
  • The findings highlight the potential benefit of combining treatments and the importance of timing rebiopsies for optimizing therapy in NSCLC cases with uncommon mutations.
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Background: Metastatic pancreatic tumors from lung cancer (MPTLC) constitute 3% of all metastatic pancreatic tumors. We present an extremely rare case of cystic MPTLC that was difficult to distinguish from intraductal papillary mucinous neoplasm (IPMN).

Case Presentation: The patient was a 74-year-old woman who underwent lobectomy of lung cancer 2 years before presentation to our hospital.

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Patients with systemic sclerosis (SSc) develop various vasculopathy-induced vascular disorders such as Raynaud's phenomenon, abnormal nail-fold capillaries, persistent digital ischemia, digital ulcers (DU), and sometimes develop renal crisis and pulmonary artery hypertension (PAH), affecting prognosis. Earlobe crease (ELC), also known as Frank's sign, is a wrinkle extending from the tragus to the outer border of the earlobe and is generally recognized as the sign of cardiovascular events. However, no previous study analyzed the association between ELC and SSc.

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Objectives: Anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody-positive and age at onset ≥60 years are poor prognosis factors in polymyositis (PM) and dermatomyositis (DM) associated with interstitial lung disease (ILD) among Japanese patients. However, the influence of age on the clinical features of anti-MDA5 autoantibody-positive patients with DM remains unclear.

Methods: We retrospectively examined 40 patients with DM and anti-MDA5 autoantibodies according to age.

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  • The study evaluated the effectiveness of using pegfilgrastim as a preventive treatment alongside docetaxel and ramucirumab for non-small cell lung cancer (NSCLC) in Japanese patients, as febrile neutropenia (FN) is a common issue with these medications.
  • Out of 20 patients enrolled, only one experienced FN, giving a low FN rate of 5%, while the overall response and disease control rates were 40% and 85%, respectively.
  • The study concluded that the combination treatment appears to be safe and effective, with significant survival rates, but emphasizes the need for close monitoring of adverse events in elderly patients.
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Anti-melanoma differentiation-associated gene 5 (MDA5) antibody has been recognized to be significantly associated with a subset of dermatomyositis patients with rapidly progressive interstitial lung disease (RP-ILD). To elucidate the clinical characteristics and poor prognostic factors in Japanese dermatomyositis patients with anti-MDA5 antibody. Clinical features of anti-MDA5 antibody-positive dermatomyositis patients and risk factors, potentially associated with a poor prognosis, were retrospectively analysed.

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Ectopic protein with proper steric structure was efficiently loaded onto the envelope of the F gene-defective BC-PIV vector derived from human parainfluenza virus type 2 (hPIV2) by a reverse genetics method of recombinant virus production. Further, ectopic antigenic peptide was successfully loaded either outside, inside, or at both sides of the envelope of the vector. The BC-PIV vector harboring the Ebola virus GP gene was able to elicit neutralizing antibodies in mice.

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Background: Dermatomyositis (DM) with autoantibody against melanoma differentiation-associated gene-5 (MDA5) is characterized by elevated risk of rapidly progressive interstitial lung disease (RP-ILD) with a potentially fatal course. Pneumomediastinum (PNM) is a common pulmonary manifestation which accompanies ILD. However, the clinical features of the patients with anti-MDA5 antibody-positive DM who develop PNM remain unclear.

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Objectives: Positron emission tomography (PET) using 2-deoxy-2-[F] fluoro-D-glucose (F-FDG) is a clinically useful modality for cancer evaluation. The mechanism of F-FDG uptake within cancer cells involves the glucose transporter 1 (GLUT1) and hypoxia-inducible factor-1 α (HIF-1α). Although recent research has shown its clinical efficacy in small-cell lung cancer (SCLC), no suitable biomarker has been identified.

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Background: Esophageal motility abnormalities (EMAs) and interstitial lung diseases (ILDs) are often seen in patients with systemic sclerosis (SSc). Gastroesophageal reflux disease (GERD) could be associated with ILDs, but it is not fully understood if ILDs are caused by GERD or SSc itself.

Methods: A total of 109 patients with SSc who underwent high-resolution manometry were enrolled.

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  • Defective phagocytosis in alveolar macrophages is linked to chronic obstructive pulmonary disease (COPD), and the role of TRPV2, a nonselective cation channel, in COPD development is investigated.
  • In experiments using murine alveolar macrophages and mice exposed to cigarette smoke, TRPV2 expression and phagocytosis function were found to decrease, particularly in TRPV2 knockout mice.
  • The findings suggest that reduced TRPV2 levels weaken macrophage phagocytosis, making lungs more vulnerable to damage from cigarette smoke, indicating that TRPV2 may be a potential therapeutic target for COPD.
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  • Oncolytic virotherapies, like coxsackievirus B3 (CVB3), show promise in treating cancer by targeting tumors while avoiding normal cells; the challenge has been CVB3’s non-specific toxicity to healthy cells.* -
  • Researchers improved CVB3’s safety by inserting microRNA target sequences that specifically respond to miR-34a/c, which is more prevalent in normal cells, preventing viral replication in these tissues.* -
  • The resulting double-miR-34a targeting virus (53a-CVB) was found to be minimally toxic to normal cells while effectively attacking cancer cells in mice, marking a significant advancement for safer anti-cancer treatments.*
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