Pleuroparenchymal Fibroelastosis (PPFE)

( Takafumi Suda ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0

Pleuroparenchymal fibroelastosis (PPFE) is a rare interstitial lung disease characterized by predominantly upper lobe fibrosis involving the pleura and subpleural lung parenchyma. PPFE has been classified as either idiopathic or secondary. Idiopathic PPFE (iPPFE) is currently defined as a rare but distinct disease entity in the updated international classification of idiopathic interstitial pneumonias (IIPs) by ATS/ERS, while secondary PPFE is associated with a variety conditions, such as transplantation, dust exposure, autoimmune diseases, and genetic mutations. Although the precise pathogenesis remains unclear, it may represent a pattern of chronic lung injury in response to various stimuli and/or in association with immune dysregulation or genetic factors, such as telomerase-associated genes. Typically, a dry cough and dyspnea are most common symptoms. Patients with PPFE show a “flat chest” with a lean body and restrictive impairments with increased residual volume (RV)/total lung capacity (TLC) on pulmonary function test. Chest x-ray shows bilateral pleural thickening and a parenchymal band in the apical portion. HRCT exhibits bilateral subpleural dense consolidation with traction bronchiectasis and reticulation. 60-90% of patients with iPPFE also have the co-existing lower-lobe interstitial lung disease (ILD). Histologically, markedly dense fibrosis of the pleura and subpleural parenchyma, with an abrupt transition to a normal parenchyma, is found. Subpleural parenchymal fibrosis is characterized by intra-alveolar fibrosis with the prominent deposition of elastic fibers. Although there are no established biomarkers, SP-D and/or KL-6 are likely to be elevated. We previously reported urinary desmosine, which is a degradation product of elastin, as a promising biomarker for the diagnosis of iPPFE. Surgical lung biopsy is essential for a definitive PPFE diagnosis, but it is often difficult because of poor pulmonary function and persistent post-operative pneumothorax. Thus, several clinical diagnostic criteria have recently been proposed. With no effective therapy currently established, its prognosis has remained poor (5-year survival: 30-50%, median survival: 3 years). Regarding prognostic factors, the co-existing lower-lobe ILD, lower FVC, a history of pneumothorax, and male sex have been shown to be significantly associated with a poor prognosis. The radiologic PPFE-like pattern is also observed in ILDs other than PPFE and is related to a poor prognosis. The number of studies on PPFE has markedly increased in the last decade. Therefore, our knowledge on PPFE has significantly expanded. However, there are still many issues that need to be elucidated, including the pathogenesis, pathophysiology, and treatment of PPFE. Future research will clarify these issues.

POSTERS / PM-008 : EFFECT OF ERYTHROMYCIN ON ATP-INDUCED INTRACELLULAR CALCIUM RESPONSE IN A549 CELLS

(Dong Mei Zhao),(Takafumi Suda),(Kingo Chida),(Hai Hui Xue),(Arata Ichiyama),(Hirotoshi Nakamura) 한국생화학분자생물학회 (구 한국생화학회) 1999 6th IUBMB SEOUL CONFERENCE Vol.- No.-

Intramedullary rod insertion places the femoral component more laterally during Oxford medial unicompartmental knee arthroplasty

( Toshikazu Tanaka ),( Yoshihito Suda ),( Tomoyuki Kamenaga ),( Akira Saito ),( Takaaki Fujishiro ),( Koji Okamoto ),( Takafumi Hiranaka ) 대한슬관절학회 2022 대한슬관절학회지 Vol.34 No.-

Background: This study aims to assess the influence of intramedullary rods on the implantation positions of femoral components using Microplasty instrumentation in Oxford unicompartmental knee arthroplasty. We hypothesized that femoral components can be laterally implanted incorrectly when using intramedullary rods. Methods: This prospective study included all 45 consecutive patients (53 knees) who underwent Oxford unicompartmental knee arthroplasty surgery for anteromedial osteoarthritis or spontaneous osteonecrosis of the knee at our hospital during the study period. A custom-made toolset comprising a triangular caliper and circular trial bearings was used to evaluate the distance between the bearing and the vertical wall of the tibia implant (wall-bearing space) using the caliper at 90° flexion both with and without intramedullary rods. Results: The wall-bearing space was significantly larger when the intramedullary rod was used than when intramedullary rod was not used (1.8 ± 1.1 mm versus 3.4 ± 1.2 mm, P < 0.001). The mean difference of wall-bearing space with and without intramedullary rod was 1.6 ± 0.7 mm. Conclusions: Femoral components can be laterally implanted incorrectly by an average of 1.6 mm when using intramedullary rods. The wall-bearing space should be evaluated using trial components, and if the relationship is improper, it should be corrected before keel slot preparation.

Usefulness of Colored 3D Imaging of Respiratory Impedance in Asthma

Toshihiro Shirai,Kazutaka Mori,Masashi Mikamo,Yuichiro Shishido,Takefumi Akita,Satoru Morita,Kazuhiro Asada,Masato Fujii,Takafumi Suda,Kingo Chida 대한천식알레르기학회 2013 Allergy, Asthma & Immunology Research Vol.5 No.5

Purpose: Recently, the clinical application of the forced oscillation technique (FOT) has progressed with the spread of commercially available FOT devices, including the impulse oscillation system and MostGraph. We investigated the usefulness of color 3D imaging of respiratory impedance in asthma using MostGraph. Methods: Whole-breath and within-breath respiratory system resistance (Rrs) and reactance (Xrs) were measured in 78 patients with asthma. Color 3D images were classified into three patterns: the chronic obstructive pulmonary disease (COPD)-like pattern (high values of Rrs and Xrs with a marked respiratory cycle and frequency dependence), the asthma pattern (moderately high Rrs over the entire frequency and a respiratory cycle with slight Xrs changes), and a normal-like pattern (low Rrs and Xrs with few within-breath changes). The classification was performed by three researchers, who were unaware of the clinical information, and the clinical characteristics were compared among the three groups. Results: Color 3D imaging provided a COPD-like pattern in 25 patients, an asthma pattern in 39 patients, and a normal-like pattern in 14 patients. Patients with the COPD-like pattern were predominantly female with a higher body mass index, lower forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and higher Rrs and Xrs values (whole-breath and within-breath variation). Those with the normal pattern had higher FEV1 and FVC, and a lower single-breath nitrogen washout slope. There were no differences in asthma control or exhaled nitric oxide levels among the three groups. Conclusions: These results suggest that color 3D imaging of respiratory impedance may show asthma phenotypes.

Rapid Changes in Serum Lipid Profiles during Combination Therapy with Daclatasvir and Asunaprevir in Patients Infected with Hepatitis C Virus Genotype 1b

Takeshi Chida,Kazuhito Kawata,Kazuyoshi Ohta,Erika Matsunaga,Jun Ito,Shin Shimoyama,Satoru Yamazaki,Hidenao Noritake,Tetsuro Suzuki,Takafumi Suda,Yoshimasa Kobayashi 거트앤리버 소화기연관학회협의회 2018 Gut and Liver Vol.12 No.2

Background/Aims: Changes in lipid profiles in patients infected with hepatitis C virus (HCV) during direct-acting antiviral therapy have been reported in recent years. However, the clinical aspects of disturbed lipid metabolism in chronic HCV infection have not been fully elucidated. Methods: Dynamic changes in serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol and apolipoprotein levels in patients infected with HCV genotype 1b were examined during combination therapy with daclatasvir (DCV) and asunaprevir (ASV). Results: Total, LDL-, and HDL-cholesterol levels increased rapidly and persistently after week 4. Apolipoprotein (apo) A-I, apo B, apo C-II, and apo C-III levels were significantly higher at week 4 than at week 0. In contrast, apo A-II and apo E levels were significantly lower. The differences in LDL- and HDL-cholesterol levels were positively correlated with those of apo B and apo A-I, respectively. Interestingly, in patients with non-sustained virological response, these cholesterol levels decreased rapidly after viral breakthrough or viral relapse. Furthermore, similar changes were observed for apo A-I, apo B and apo C-III levels. Conclusions: Clearance of HCV using combination therapy with DCV and ASV results in rapid changes in serum lipid profiles, suggesting an influence of HCV infection on disturbed lipid metabolism.