基本情報
- 所属
- 自治医科大学 附属病院臨床研究センター臨床研究・治験推進部 教授
- 学位
- 博士(医学)(自治医科大学(JMU))
- J-GLOBAL ID
- 200901063180060405
- researchmap会員ID
- 1000231412
研究キーワード
2研究分野
1受賞
2-
1998年
-
1995年
論文
74-
EUROPEAN RESPIRATORY JOURNAL 45(5) 1382-1392 2015年5月 査読有りA randomised, double-blind, phase II, dose escalation trial was conducted to assess the safety, tolerability and pharmacokinetics of the tyrosine kinase inhibitor nintedanib, alone and when added to ongoing pirfenidone therapy, in Japanese patients with idiopathic pulmonary fibrosis. 50 Japanese patients were randomised to receive nintedanib or placebo in one of three cohorts (nintedanib 50 mg twice daily or 100 mg twice daily for 14 days, or 150 mg twice daily for 28 days). Patients receiving pirfenidone at inclusion were stratified to every nintedanib dose group and placebo. Adverse events were reported in nine out of 17 patients receiving nintedanib alone and 10 out of 21 patients receiving nintedanib added to pirfenidone. All adverse events were mild or moderate in intensity. Gastrointestinal disorders were the most common adverse event Maximum plasma concentration and area under the curve at steady state for nintedanib and its metabolites tended to be lower when nintedanib was added to pirfenidone. Nintedanib had no effect on the pharmacokinetics of pirfenidone. In conclusion, further study is needed to evaluate the safety and tolerability profile of nintedanib when added to pirfenidone in patients with idiopathic pulmonary fibrosis. There was a trend toward lower exposure of nintedanib when it was added to pirfenidone.
-
Respiratory Investigation 53(2) 51-59 2015年3月1日 査読有りBackground: There have been no prospective large-scale multicenter epidemiological studies on the clinical course and treatment from the time of diagnosis of idiopathic interstitial pneumonias (IIPs) in Japan. The purpose of this study was to clarify the current clinical situation of IIP in Japan. Methods: This study was supported by a grant from the Ministry of Health, Labour and Welfare to the Diffuse Lung Diseases Research Group. Data including clinical findings, course, and treatment of IIP from a web database created by a collaborative effort of medical institutions across Japan that specialize in the care of interstitial pneumonias were collected and analyzed. Results: A total of 436 IIP patients from 19 institutions were newly registered during a 5-year period. Idiopathic pulmonary fibrosis (IPF) was the most frequently encountered IIP, and 28% of the IPF cases were initially diagnosed by abnormal chest X-ray or CT in asymptomatic patients. Until the 2008 fiscal year, no treatment was given for most cases of IPF. After the end of 2008, when pirfenidone was approved for manufacture, the number of patients for whom no treatment was recommended declined, and pirfenidone therapy was initiated in 32.9% of cases in 2009. The median survival times for IPF from the onset symptoms and from the initial visit were 105 months and 69 months, respectively. Conclusions: This study should provide valuable information for understanding the current state of IIP in Japan.
-
The Journal of biological chemistry 290(8) 5065-5077 2015年2月 査読有り
-
RESPIRATORY MEDICINE 109(2) 272-278 2015年2月 査読有りBackground: National surveys conducted in Japan between 1960 and 2004 suggest a gradually increasing incidence of sarcoidosis in women >50 years old with increased involvement of the eye, skin, and heart. However, whether this involvement is due to the increased age at diagnosis is still unclear. We aimed here to identify the age-related differences in organ involvement in sarcoidosis in Japan, as well as the historical changes in clinical characteristics and the age-specific distribution of cases at diagnosis. Methods: We reviewed 588 consecutive Japanese patients newly diagnosed with sarcoidosis between 1974 and 2012 at Jichi Medical University Hospital. We compared organ involvement between subgroups differentiated by sex and age (<45 years; n = 275; >= 45 years; n = 313) at diagnosis and identified historical changes in the age-specific distribution in 10-year intervals. Results: Younger patients had more common involvement of extrathoracic lymph nodes, parotid/salivary gland, and liver, while older patients had more common involvement of nonlymphatic extrathoracic organs such as the eye, heart, muscle, and kidney. The age at diagnosis has consistently increased over the past four decades. The monophasic distribution in men has tended to become biphasic, and the biphasic distribution in women monophasic. Increasing trends were apparent for hypercalcemia and involvement of the gastrointestinal tract, skin, nervous system, muscle, and kidney. Conclusions: Elderly patients at diagnosis had various extrathoracic involvement including eye, skin, and cardiac lesions. Moreover, the age at diagnosis of sarcoidosis has continued to increase in both sexes, influencing the recent trends in clinical characteristics. (C) 2015 Elsevier Ltd. All rights reserved.
-
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 190(7) 773-779 2014年10月 査読有りRationale: Idiopathic pulmonary fibrosis (IPF) has an unknown etiology and poor prognosis. Several large-scale epidemiologic studies have been conducted predominantly in Western countries. There are few studies reported from Asian countries. It remains unclear whether ethnic difference exists in IPF. It is important to determine the current IPF status in Asian populations and compare it with that of Western populations. Objectives: To provide the epidemiologic status of IPF in Japan and to investigate ethnic differences. Methods: We selected Hokkaido prefecture (population, 5.6 million) as the epidemiologic cohort of IPF among Japanese. On the basis of the clinical records of 553 patients with IPF who were accepted based on the application of the Certificate of Medical Benefit between 2003 and 2007, we conducted a retrospective epidemiologic and prognostic analysis. Measurements and Main Results: The prevalence and cumulative incidence of IPF was 10.0 and 2.23 per 100,000 population, respectively, with 72.7% predominance of males and an increase in frequency with age. The median survival time was 35 months, and the most common (40%) cause of death was acute exacerbation. The most important factor influencing IPF prognosis was the percent vital capacity. Conclusions: The status of IPF in the Japanese population was clarified for the first time through our study. Our results showed that in men, the incidence of death caused by acute exacerbation was higher and that caused by cardiovascular disease was lower in Japan than in Western countries. These results may suggest ethnic differences in IPF.
MISC
182-
気管支学 : 日本気管支研究会雑誌 23(7) 655-655 2001年11月25日
-
日本呼吸器学会雑誌 = The journal of the Japanese Respiratory Society 39(5) 322-327 2001年5月10日
-
日本呼吸器学会雑誌 = The journal of the Japanese Respiratory Society 38(12) 918-922 2000年12月10日
-
日本呼吸器学会雑誌 = The journal of the Japanese Respiratory Society 38(11) 865-869 2000年11月10日
-
気管支学 : 日本気管支研究会雑誌 22(6) 480-480 2000年9月25日
-
日本呼吸器学会雑誌 = The journal of the Japanese Respiratory Society 37(10) 829-833 1999年10月10日
-
RESPIRATORY MEDICINE 93(7) 507-514 1999年7月Elevated plasma brain natriuretic peptide (BNP) levels have been described in patients with congestive heart failure and acute myocardial infarction. We measured plasma BNP levels in patients with chronic respiratory failure to evaluate the correlation between plasma BNP levels and pulmonary haemodynamics. Plasma BNP levels were measured in 28 patients with chronic respiratory failure accompanied by three underlying diseases [14 with chronic obstructive pulmonary disease (COPD), seven with sequelae of pulmonary tuberculosis (sequelae Tbc) and seven with diffuse panbronchiolitis (DPB)] by immunoradiometric assay methods (IRMA). Twenty-one of 28 patients had already received oxygen supplementation and 16 of 21 patients were treated as outpatients with home oxygen therapy. Plasma BNP levels were significantly elevated in patients with chronic respiratory failure complicated by cor pulmonale (81.5 +/- 13.1 pg ml(-1)) compared to patients without cor pulmonale (13.3 +/- 2.7 pg ml(-1), P<0.001). As controls, plasma BNP levels in 10 patients with primary lung cancer were studied, and the results (3.5 +/- 1.0 pg ml(-1)) were not significantly different from those of patients with chronic respiratory failure without cor pulmonale. Plasma BNP levels in 12 healthy subjects were also studied, and the results (7.2 +/- 1.0 pg ml(-1)) were not significantly different from those of the control subjects. Plasma BNP levels showed a weak linear correlation with systolic pulmonary arterial blood pressure, estimated by Doppler echocardiography (r=0.43; P=0.068), but there was no significant correlation between BNP levels and the degree of hypoxaemia (r=0.30; P=0.138). Plasma atrial natriuretic peptide (ANP) levels in patients with chronic respiratory failure were also measured using the same samples. Plasma ANP levels were also significantly elevated in patients with chronic respiratory failure complicated by cor pulmonale (80.8 +/- 12.1 pg ml(-1)) compared to patients without cor pulmonale (26.1 +/- 4.4 pg ml(-1), P=0.003). A significant correlation was found between plasma BNP and ANP levels (r=0.68; P<0.001). Our results suggest that the plasma BNP or ANP level may be a useful indicator for detecting the presence of cor pulmonale in patients with chronic respiratory failure.
-
気管支学 : 日本気管支研究会雑誌 21(4) 308-311 1999年5月25日胸膜転移をきたした悪性黒色腫の1例を経験した。症例は64歳, 女性。右背部上方の悪性黒色腫(stage I a)に対し, 手術および化学療法を施行した。10年後, 皮膚・肝に再発を認めたため, 再度, 化学療法を施行したが, その14ヵ月後, 右胸痛, 咳嗽および労作時呼吸困難が出現し, 胸部X線写真にて大量の胸水貯留を認めた。また, 胸部CT写真で左S^3, S^4, S^8の3ヵ所にそれぞれ結節を認めた。胸水のコントロールを目的に胸腔ドレーンを挿入する際に局所麻酔下胸腔鏡検査を施行し, 小豆様の黒色隆起性病変を臓側および壁側胸膜に散在性に多数認めた。同部位からの直視下生検にて悪性黒色腫の胸膜転移との確定診断を得た。原因不明の胸水貯留例に対する局所麻酔下胸腔鏡は胸腔内病変の詳細な観察および直視下生検による病理組織学的診断率の向上が期待できる, 安全かつ有用な検査法である。
-
気管支学 : 日本気管支研究会雑誌 21(4) 312-312 1999年5月25日
-
気管支学 : 日本気管支研究会雑誌 21(3) 172-172 1999年4月25日
-
アレルギー 48(2) 258-258 1999年3月30日
-
炎症 : 日本炎症学会雑誌 : Japanese journal of inflammation 19(1) 39-46 1999年1月30日
-
Nitrite/Nitrate levels in broncloalueolar lavage fluid from patients with interstitial lung diseasesAmerican Journal of Respinatory and Critical Care Medicine 158 A67 1999年
-
肺癌 38(6) 661-668 1998年10月1日1985年から1996年までに当科に入院した原発性肺癌720例のうち脳転移を認めた90例を、脳転移診断時の神経症状の有無により有症状群(n=54)、無症状群(n=36)に分け両群の比較検討を行った。両群間において、年齢、性、組織型、丁因子、N因子、他臓器転移の有無については差を認めなかった。経過中に脳転移が診断された例では、有症状例が多い傾向が認められた。転移がテント下に存在する場合には、テント上のみの転移の場合に比べ、症状出現率は有意に高かった。転移巣の大きさは有症状群で有意に大であった。放射線療法単独もしくは化学療法との併用療法に対する腫瘍縮小効果は両群で差はなく、有症状群では83。3%の高い症状改善卒が得られた=。脳転移診断からの生存期間は両群で差を認めなかった。脳転移が直接死因となった4症例はすべて有症状群であった。放射線療法は有症状脳転移の制御においても有効と言えるが、併用化学療法の効果についてはさらに検討が必要であると思われた。
-
気管支学 : 日本気管支研究会雑誌 20(3) 272-272 1998年4月25日
-
American Journal of Respiratory and Critical care Medicine 157(3) A205 1998年
Works(作品等)
2共同研究・競争的資金等の研究課題
2-
科学研究費補助金
-
Grant-in-Aid for Scientific Research