Publications by authors named "Kazuhiko Shien"

Objective: Currently, the two methods used to preserve lungs from uncontrolled donation after circulatory death-topical cooling and inflation-result in the suboptimal utilization of lungs. This study aimed to introduce an approach that combines cooling and inflation to investigate whether it improves lung conditions in a swine model, even if the lungs had been damaged with long-term warm ischemia, such as in out-of-hospital cardiac arrest.

Methods: Donor lungs subjected to 1.

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Objectives: Adjuvant osimertinib is currently the standard of care after pulmonary resection in patients with non-small cell lung cancer (NSCLC) harbouring an activating epidermal growth factor receptor (EGFR) mutation. Several guidelines recommended up to 4 cycles of adjuvant platinum-doublet before adjuvant osimertinib treatment. However, whether adjuvant platinum-doublet prolongs the overall survival (OS) of patients with EGFR-mutated NSCLC as it did in the unselected LACE meta-analysis cohort is unclear.

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Bronchoscopic lung volume reduction( BLVR) and lung volume reduction surgery( LVRS) represent two complementary strategies in the management of advanced emphysema. BLVR has emerged as a minimally invasive and reversible approach, demonstrating significant clinical benefit in carefully selected patients without collateral ventilation, supported by advances in physiological assessment and imaging technologies. LVRS, by contrast, remains a well-validated surgical option offering sustained improvements in pulmonary mechanics, exercise tolerance, and quality of life, particularly in patients with heterogeneous upper-lobe predominant disease.

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Background: Postoperative osimertinib for EGFR mutant non-small cell lung cancer has become the standard of care. However, its adverse events in clinical practice remain unclear. We report a case of interstitial lung disease and pulmonary embolism occurring simultaneously as adverse events during adjuvant osimertinib treatment.

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A 60-year-old male with COPD underwent right single lung transplantation. Despite progressive hyperinflation of the native left lung, the transplanted lung maintained function, as downward expansion of the left lung displaced the diaphragm without compressing the mediastinum. This suggests diaphragm mobility, aided by the absence of the liver beneath the left diaphragm, contributes to favorable outcomes in right single lung transplantation by preventing mechanical compression of the transplanted lung.

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Objectives: This report highlights a clinical case of recurrent diffuse panbronchiolitis (DPB) after bilateral lung transplantation (LTx), with a focus on the therapeutic impact of off-label inhaled tobramycin solution for inhalation (TSI) in managing Pseudomonas aeruginosa colonization.

Methods: A Japanese woman with a history of DPB experienced disease recurrence following bilateral LTx. Persistent colonization by P.

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Purpose: Although rare, primary chest wall sarcomas are complex malignancies necessitating optimal local control and comprehensive treatment. This study aimed to review 9 years of cases of primary chest wall sarcomas at a single institution, focusing on their histology, surgical management, and prognosis.

Methods: A retrospective analysis was performed on 19 patients undergoing chest wall resection for sarcoma from 2012 to 2020.

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Background: Segmentectomy for lung cancer has been increasingly performed. However, evidence regarding the necessity of additional surgical resection after the diagnosis of unsuspected N1 or N2 lymph node metastasis is limited.

Methods: We conducted a multicenter, real-world data study of patients with any clinical T and N0 non-small cell lung cancer (NSCLC) who underwent lobectomy or segmentectomy between 2012 and 2021 and who subsequently received a diagnosis of pathologic N1 or N2 lymph node metastasis.

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Background: While Epidermal growth factor receptor (EGFR) mutation-positive lung adenocarcinoma (LUAD) has favorable outcomes with targeted therapy, early-stage prognosis remains influenced by pathological factors and central nervous system (CNS) recurrence. The study aimed to clarify prognostic factors in pathological stage (pStage) I EGFR mutation-positive LUAD.

Methods: Between 2015 and 2018, 2,191 pStage I LUAD cases with known EGFR status (excluding EGFR testing after recurrence) who received anatomical resection were included from multiple institutions in Japan.

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Article Synopsis
  • - The study examined the role of programmed cell death-ligand 1 (PD-L1) expression and epidermal growth factor receptor (EGFR) mutations as biomarkers for lung adenocarcinoma, analyzing data from 847 patients across 21 centers in Japan from 2015 to 2018.
  • - Results showed that while PD-L1 expression was linked to shorter recurrence-free survival (RFS) in both EGFR-mutant and wild-type patients, it had no effect on overall survival (OS) in EGFR-mutant patients.
  • - The findings suggest that PD-L1 expression is a poor predictor of OS for EGFR-mutant patients and does not influence the effectiveness of post-relapse treatment with EGFR-
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Background: Management of tacrolimus trough levels (TTLs) influences morbidity and mortality after lung transplantation. Several studies have explored pharmacokinetic and artificial intelligence models to monitor tacrolimus levels. However, many models depend on a wide range of variables, some of which, like genetic polymorphisms, are not commonly tested for in regular clinical practice.

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Purpose: Bronchopleural fistula (BPF) is a serious complication of lung resection. To avoid BPF, the bronchial stump/anastomotic site is often covered with a flap of surrounding tissue. One risk factor for BPF is radical lung resection after induction chemoradiotherapy for lung cancer.

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Background: Since lung transplant recipients (LTRs) exhibit low immunogenicity after two doses of SARS-CoV-2 mRNA vaccines, optimal vaccine strategies for SARS-CoV-2 are required in LTRs. This study aimed to investigate the efficacy and safety of the third and fourth doses of the SARS-CoV-2 mRNA vaccines in LTRs.

Methods: We conducted a single-center study of 73 LTRs and 23 healthy controls (HCs).

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Article Synopsis
  • The study focuses on understanding how lung cancer cells develop resistance to crizotinib, a MET tyrosine kinase inhibitor, particularly in cases of MET amplification.
  • Researchers established two MET-amplified lung cancer cell lines, EBC-1 and H1993, to explore the mechanisms behind this acquired resistance, using genomic and transcriptomic data for analysis.
  • Findings revealed various resistance mechanisms, including SERPINE1 overexpression in EBC-1 cells and potential therapies like PAI-1 inhibitors or MEK inhibitors for overcoming resistance in these cancer cells.
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Background: Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic biomarker in non-small cell lung cancer (NSCLC); however, the underlying biological rationale remains unclear. The present study aimed to explore the potential utility of NLR as a surrogate biomarker for immune response to cancer and to elucidate the underlying mechanism.

Methods: This retrospective study included the medical records of 120 patients with NSCLC who underwent surgery at the study institution in 2012.

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Doublecortin (DCX)-positive neural progenitor-like cells are purported components of the cancer microenvironment. The number of DCX-positive cells in tissues reportedly correlates with cancer progression; however, little is known about the mechanism by which these cells affect cancer progression. Here we demonstrated that DCX-positive cells, which are found in all major histological subtypes of lung cancer, are cancer-associated Schwann cells (CAS) and contribute to the chemoresistance of lung cancer cells by establishing an adrenergic microenvironment.

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Purposes: Robot-assisted thoracoscopic (RATS) segmentectomy is becoming increasingly common because of the expanded indications for segmentectomy and the widespread adoption of robotic surgery. The precise division of the intersegmental plane is necessary to ensure oncologic margins from the tumor and to preserve the lung function. In this study, we present a strategy for accurately dividing the intersegmental plane using a robotic stapler and review the surgical outcomes.

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Background: Living donor lobar lung transplantation is a life-saving procedure for critically ill patients. This requires 2 healthy donors exposed to risks and without medical benefit. Therefore, the donor's safety and minimal postoperative complications are crucial.

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Article Synopsis
  • - The study examines how radiation pneumonitis (RP) affects prognosis in patients with locally advanced non-small cell lung cancer (LA-NSCLC) who received chemoradiotherapy followed by surgery, focusing on the neutrophil-to-lymphocyte ratio (NLR).
  • - Researchers analyzed data from 168 patients, dividing them into those who experienced RP (41 patients) and those who did not (127 patients), and found that RP patients had specific clinical traits and higher postoperative NLR.
  • - Findings suggest that a lower postoperative NLR is linked to better outcomes, indicating that NLR could serve as a valuable prognostic tool, even for those suffering from RP.
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  • - The study analyzed the effects of central nervous system (CNS) metastasis on performance status, treatment responses, and survival rates in lung adenocarcinoma patients with common EGFR mutations following surgical resection.
  • - Out of 4181 patients, 78 experienced CNS metastasis, which was more common in those receiving conventional adjuvant chemotherapy; however, this treatment showed no significant benefits in relapse-free survival or overall survival post-relapse.
  • - The findings suggest that CNS metastasis doesn't noticeably impact performance status or alter treatment efficacy with EGFR-tyrosine kinase inhibitors, indicating a need for more studies on managing CNS metastasis in the context of adjuvant TKI therapies.
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Objectives: Histidine-rich glycoprotein has been reported as an anti-inflammatory glycoprotein that inhibits acute lung injury in mice with sepsis and as a prognostic biomarker in patients with sepsis. We investigated the relationship between plasma concentrations of histidine-rich glycoprotein and the risk of occurrence of primary graft dysfunction.

Methods: According to the primary graft dysfunction grade at post-transplant 72 h, patients who underwent lung transplantation were divided into three groups: non-primary graft dysfunction group (grade 0-1), moderate primary graft dysfunction group (grade 2), and severe primary graft dysfunction group (grade 3).

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Article Synopsis
  • CAF-derived POSTN is significantly overexpressed in non-small cell lung cancer (NSCLC) compared to normal fibroblasts, contributing to tumor growth and progression.
  • POSTN promotes cell proliferation and enhances the ability of NSCLC cells to undergo epithelial-mesenchymal transition (EMT) through activation of the ERK signaling pathway.
  • Knocking down POSTN in cancer-associated fibroblasts improves the effectiveness of osimertinib treatment in EGFR-mutant NSCLC cells, suggesting that targeting POSTN could be a promising therapeutic approach.
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Background: The presence of tumor-infiltrating lymphocytes (TILs) and tertiary lymphoid structures (TLSs) in tumor tissue has been related to the prognosis in various malignancies. Meanwhile, neutrophil-to-lymphocyte ratio (NLR) as a systemic inflammation marker also has been associated with the prognosis in them. However, few reports have investigated the relationship between pulmonary metastases from sarcoma and these biomarkers.

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