Koichi Fujiu

Clinical utility of comprehensive genomic profiling in thoracic malignancies beyond conventional gene testing

Satoshi Muto, Masaru Hisa, Jun Osugi, Koichi Fujiu et autres

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Adrenal Insufficiency due to Hypophysitis One Year and 10 Months After Discontinuation of Durvalumab: a Case Report

Koichi Fujiu, Kawori Ebinuma, Mutsuya Watanabe, Hiroyuki Suzuki

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A Case of Recurrent Cytokine Release Syndrome Following Neoadjuvant Chemotherapy Including Nivolumab for Lung Squamous Cell Carcinoma: Successful Treatment with Steroid Pulse Therapy and Tocilizumab

Kosuke Fujishima, Jun Osugi, Koichi Fujiu, Mitsunori Higuchi et autres

背景．サイトカイン放出症候群（cytokine release syndrome：CRS）は発熱から始まり幅広い症状を呈するが，時として播種性血管内凝固症候群や多臓器不全など重度の症状を引き起こす．CRSの症状は敗血症と類似しており，鑑別が困難であり治療開始が遅れることがある．免疫チェックポイント阻害薬を誘因としたCRSに対して，ステロイドパルス療法やトシリズマブでの早期治療介入により救命できた症例を経験した．症例．cT4N2M0：IIIB期の肺扁平上皮癌（tumor proportion score：90～100%）と診断された70歳男性が，ニボルマブを含んだ術前化学療法を受けた．2コース目投与6日後に40℃の発熱，低血圧，頻脈を認めた．臓器障害の併発も認めた．血液培養は陰性であり，CRSを疑った．発症翌日にステロイドパルス療法を行った．ステロイド投与開始約1か月後にCRSが再燃するも，トシリズマブを早期に投与することで症状は劇的に改善した．結論．免疫チェックポイント阻害薬の投与後に発熱，低血圧などの敗血症を疑う所見を認めた際には，本疾患も考慮し迅速かつ適切な対応が必要である．

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Patient with Pleural Mesothelioma and Direct Bilirubin-predominant Constitutional Jaundice Treated with a Combination of Nivolumab and Ipilimumab

Koichi Fujiu, Masaru Hisa, Jun Osugi, Hiroyuki Suzuki

Background. Patients with pleural mesothelioma and constitutional jaundice characterized by predominantly elevated direct bilirubin (DBL) are treated with a combination of nivolumab (Nivo) and ipilimumab (Ipi). Case. A 73-year-old man visited our hospital with a chief complaint of right pleural effusion. Constitutional …

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Infectious Costochondritis With Sternal Osteomyelitis

Koichi Fujiu, Yoshiyuki Maruya, Satoru Kayama, Hiroyuki Suzuki

Costochondritis is primarily caused by physical exertion, repetitive movements (such as lifting heavy objects), and severe coughing. Although it is an inflammatory condition, it is not an infection and is often treated with non-steroidal anti-inflammatory drugs (NSAIDs). In contrast, infectious costochondritis usually …

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Lattice fixation of bony thorax with absorbable sutures and chest wall reconstruction using the fascia lata for a sternal tumor: Case report

Kosuke Fujishima, Yue Cong, Jun Osugi, Koichi Fujiu et autres

胸骨腫瘍に対する胸骨切除術後の再建にはメッシュなどのシート状組織を用いることが一般的であるが，ときに十分な胸郭の安定性が得られず，術後にフレイルチェストを生じることがある．今回我々は腎細胞癌術後に胸骨転移を来した76歳男性に胸骨切除を行った．放射線治療後でもあり，感染リスクを考慮して生体組織である大腿筋膜を用いて胸壁再建を行った．胸壁欠損部が広範囲に及んだため，左右肋骨と胸骨は吸収糸を用いて格子状に固定することで胸郭を安定させた．術後にフレイルチェストは認めず，術後16日目に退院した．胸壁再建の際に，吸収糸による格子状の固定の有用性を考察とともに報告する．

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Robotic Lobectomy with a Single Robotic Stapler from One 12-mm Port: A Multi-institutional Study

Yoshimasa Inoue, Koichi Fujiu, Tetsuya Endo, Rurika Hamanaka et autres

Introduction of the robotic stapler has allowed robotic lobectomy to be performed from a surgical console in complete autonomy. The robotic stapler fits a 12-mm port, which is larger than the standard 8-mm port and increases the risk of postoperative pain. However, …

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Uniportal Thoracoscopic Bisegmentectomy of Medial and Posterior Basal Segment (S7+S10)

Yue Cong, Masaaki Nagano, Kosuke Fujishima, Jun Osugi et autres

When a tumor is located in the medial (S7) or posterior (S10) basal segment, it is sometimes necessary to perform a bisegmentectomy of S7 and S10 (S7+S10) to achieve a sufficient surgical margin. In this report, we present surgical techniques for uniportal …

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Robotic lobectomy with a single robotic stapler from one 12-mm port: a multi-institutional study

Yoshimasa Inoue, Koichi Fujiu, Tetsuya Endo, Rurika Hamanaka et autres

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Perioperative management and surgical procedure for prolonged air leak: a clinical practice review

Yue Cong, Michitaka Honda, Kosuke Fujishima, Jun Osugi et autres

Abstract: The most common postoperative complication after lung resection is prolonged air leak (PAL). Although PAL is not life-threatening, it negatively affects other perioperative outcomes. Surgical management is rarely the first choice for PAL, but there are some cases that require surgical …

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Two Cases of Retroperitoneal Fibrosis During Anti-programmed Cell Death 1 Antibody Treatment

Koichi Fujiu, Yu Utsumi, Fumito Omi, Motohisa Suzuki et autres

Background. Retroperitoneal fibrosis is characterized by fibrosis around the abdominal aorta and iliac arteries. Two-thirds of reported cases had idiopathic causes. Idiopathic retroperitoneal fibrosis is thought to result from a local inflammatory reaction to antigens in the atherosclerotic plaques of the abdominal …

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A surgical case of ciliated muconodular papillary tumor in the left lower lobe of the lung

Jun Osugi, Takeo Hasegawa, Yoshihiro Nozawa, Koichi Fujiu et autres

症例は，78歳，女性．胃癌術後経過観察目的のCTにて左肺下葉末梢に5 mm大の結節影を認め，18ヵ月の経過で8 mm大と増大傾向を認めた．診断と治療目的に胸腔鏡下肺部分切除術を施行した．病理組織学所見は，杯細胞・線毛上皮細胞が乳頭状，肺胞置換性に増殖しており，ciliated muconodular papillary tumor（CMPT：線毛性粘液結節性乳頭状腫瘍）と診断した．術後2年再発を認めていない．CMPTは，良悪性の位置づけが確立していない稀な腫瘍である．本邦における報告は，自験例も含め38例と少なく，極めて貴重な症例と考えられた．

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