Akina Komatsu

Kameda Medical Center, Kameda-honchō, Niigata, Japan

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Publications (5)2.5 Total impact

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    ABSTRACT: Although pleurodesis is an effective treatment for malignant pleural effusion, we hesitate to use in patients with poor performance status (PS) because of its side effects. Of 46 pleurodesis cases in our institution between 2006 and 2010, 24 poor PS cases (>3) were classified into 2 groups according to survival (beyond 3 months) or non-survival, and 3 groups according to condition: PS improved after pleurodesis, remained stable, or was exacerbated and we analyzed their backgrounds. Among the 24 cases (66.7%), there were 5 and 19 survival and non-survival cases. Patient backgrounds, characteristics of the lesions and examination results did not differ significantly among them. On the other hand, the ratio of successful initial pleurodesis in the exacerbated PS group was lower than in the improved and stable groups (16.7% vs. 100%, 87.5%). The 1- and 3-month survival rates of unsuccessful cases were lower than those of successful cases (33.3% vs. 77.8%, 0% vs. 32.4%). Success of initial pleurodesis can affect PS and outcome, thus it is important to improve the number of successful cases of initial pleurodesis.
    No preview · Article · Oct 2011
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    Full-text · Article · Aug 2011 · Jornal brasileiro de pneumologia: publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
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    ABSTRACT: A 64-year old male who had been treated with oral predisolone for severe bronchial asthma had started the treatment of omalizumab administration every 4 weeks since December 2009 and his symptoms had prominently improved. However, he complained the recurrence of his symptoms 4 weeks after administration of omalizumab and the mean times of SABA use had also increased from 0.61/day (1-2w) to 0.95/day (4w). Therefore, we had shortened the interval of omalizumab to 3 from 4 weeks since April 2010. Consequently, his symptoms have improved with increase of Asthma Control Test (15.67→21.33) and it has been possible to reduce the oral prednisolone. Recently, we can use the omalizumab and have extended the choice of treatment for severe bronchial asthma. However, it is predicted that there are some patients who have clinical problems for continuing the recommendation dose or intervals. We report a case with a brief review of the literature.
    No preview · Article · May 2011 · Arerugī = [Allergy]
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    ABSTRACT: Case. A 73-year-old man was referred to our hospital because of visual disturbance and retinal detachment. A physical examination showed small cell lung cancer with choroidal metastasis. Although we had scheduled chemotherapy, his ocular symptoms deteriorated, simultaneously with his performance status, and he died 1 month after his initial visit. Discussion. Although case reports of choroidal metastasis have been increasing recently, few reports of factors affecting visual prognosis are available. We identified 34 cases reported from 1988 to July 2010 in Japan with good or poor outcome, and analyzed their backgrounds and treatment. Patients with a good outcome were younger and had received more radiotherapy than those with a poor outcome. This analysis suggests that local management including radiotherapy, can be effective in cases of choroidal metastasis.
    No preview · Article · Apr 2011 · Haigan
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    ABSTRACT: A 36-year-old man with a history of asthma visited an outpatient clinic complaining of high fever and general fatigue, and was diagnosed as having influenza type A by influenza antigen test. Laboratory findings revealed mild inflammation, mild acidemia, and hypercapnea with radiologic infiltrations in the right lung, and remarkable wheezes in both lungs were heard on auscultation. He was diagnosed with asthma exacerbation and having influenza pneumonia, and was referred to us. Therapy was begun with oseltamivir for influenza infection and intravenous infusions of betamethasone and aminophylline with non-invasive pulmonary ventilation for asthma exacerbation and acute respiratory failure. Although he was weaned from mechanical ventilation and his general condition became good, electrocardiogram showed sinus bradycardia and negative T waves in V1-4 without any symptoms. Blood test and echocardiography showed almost normal findings except for slight elevation of LDH and AST. Influenza A antigen was already confirmed and he was diagnosed as having influenza myocarditis clinically. Although it is well known that influenza can cause asthma exacerbation and encephalopathy, influenza myocarditis is regarded as rare by physicians. In fact, the number of case reports about influenza myocarditis is few. Myocarditis may not appear to be serious, but could cause fatal arrhythmia and heart failure. All clinicians should be aware of the overall clinical picture and the possibility of severe complications of myocarditis caused by flu infection.
    No preview · Article · Oct 2010 · Journal of Infection and Chemotherapy