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Biomedical subjects

A Iwase

Publications and source records attributed to A Iwase.

At least 37 records · Page 2Linked to original sources
PubMed1997

[A case of humidifier lung characterized by histopathologic feature].

A 61-year-old man was discharged from our hospital after recovering from bilateral fractures in the neck of each femur. However, a productive cough, dyspnea, and a high grade fever occurred eight hours after returning home. He was thus admitted once more. At rehospitalization, there was radiographic evidence of bilateral infiltrates and hypoxemia. Hypersensitivity pneumonitis was strongly suggested by radiographic evidence, by the fact that no new drugs had been administered, and by a positive result after an environmental provocation test. A diagnosis of humidifier lung was confirmed by a positive precipitins test for humidifier water. Several microorganisms were isolated from humidifier water, and precipitins tests for the isolated microorganisms were mostly positive. Microscopic examination revealed focal alveolitis, bronchiolitis, and perivasculitis. Perivascular leucocytic infiltrations around venules suggested that inhaled antigens might have also caused humidifier lung via a vascular route. Humidifier lung may be due in part to soluble factors, such as endotoxin, present in humidifier water.

Alveolitis, Extrinsic Allergic↗
PubMed1996

Prognostic value of Ia+ T lymphocytes in bronchoalveolar lavage fluid in pulmonary sarcoidosis.

We investigated the value of the la+ T-lymphocyte (CD3+ HLA-DR+) ratio in bronchoalveolar lavage fluid (BALF) for predicting the outcome of pulmonary sarcoidosis. Analysis of the BALF la+ T% in 166 patients with pulmonary sarcoidosis by dual-color flow cytometry revealed a wide range of values, of from 0.5 to 85.3%. Although the majority of patients had less than 40% la+ T cells in their BALF, a minor peak was observed at 50 to 60%. The BALF la+ T% value was not influenced by smoking, sex, or age, thus differing from other BALF activation markers. Fifty patients could be followed up precisely for 3 yr after their initial bronchoalveolar lavage (BAL) to evaluate outcome with respect to chest X-ray findings, clinical symptoms, serum angiotensin converting enzyme (ACE) activity, and extrapulmonary involvement. The 50 patients were divided into two groups, with a BALF la+ T% < 40% (n = 34) and > or = 40% (n = 16), respectively. Serum ACE activity returned to normal within 1 yr in the < 40% group, but remained high for the entire follow-up period in the > or = 40% group. The significant difference was observed in the persistence of pulmonary involvement between the two groups except for four patients who showed Stage 0 disease (p < 0.02). Thirteen of 31 patients in the < 40% group showed normalization of chest X-ray findings after three years, whereas only one out of 15 patients in the > or = 40% group showed resolution of pulmonary involvement. Our results suggest that the BALF la+ T% may be a novel marker for predicting the long-term prognosis in pulmonary sarcoidosis.

Adolescent↗
PubMed1996

Localized fibrous mesothelioma with bronchogenic carcinoma.

We report a case of localized fibrous mesothelioma (LFM) of the pleura with bronchogenic carcinoma. LFM arose in the visceral pleura of the upper lobe in the left lung, and lung adenocarcinoma was located in the ipsilateral lower lobe. LFM is a rare mesenchymal tumor of the pleura. Concomitant occurrence with bronchogenic carcinoma has not been previously reported in the English literature.

Biopsy, Needle↗
PubMed1996

[Temporal modulation transfer function in normal-tension glaucoma patients].

In an attempt to detect patients in an early stage of glaucoma, a new screening test, the Flicker System, by which temporal modulation transfer function is evaluated, was performed in 64 normal-tension glaucoma patients and 65 normal eyes. The early stage of glaucoma, i.e., stage 0-1 of Aulhorn-Greve's classification, showed a significant decrease of the modulation in the range from 20 to 45 Hz in comparison with normal eyes (p value < 0.05). The moderate stage of glaucoma of stages 2-3 also revealed significantly decreased values of the modulation in the range from 14 to 55 Hz. In the range from 25 to 45 Hz, the reduction of modulation in the glaucoma with diffuse visual defect was more profound than in glaucoma with localized or mixed defects. The results seem to be compatible with the presence of diffuse visual function deficit in glaucoma.

Adult↗
PubMed1996

[Interstitial pneumonia associated with mixed connective tissue disease--marked improvement with azathioprine].

A 55-year-old man who complained dyspnea on exertion was given a diagnosis of interstitial pneumonia associated with mixed connective tissue disease, based on symptoms and on physical and laboratory findings. Soon afterward, he experienced an acute exacerbation of the interstitial pneumonia. He was given three courses of steroid pulse therapy and cyclophosphamide, but his condition worsened. After administration of azathioprine in addition to corticosteroids, his respiratory status improved. The dose of corticosteroids was tapered and the patient has been free of disease for two years. Pulmonary involvement in mixed connective tissue disease has been considered to be relatively benign and easily treated with corticosteroids. Recently, however, many cases of corticosteroid-resistant disease with poor outcome have been reported. Azathioprine was very effective against the interstitial pneumonia in this case, but general conclusions about the most effective type of immunosuppressive agent and the timing of its administration must await the results of further study.

Azathioprine↗
PubMed1995

[Diagnosis of Churg-Strauss syndorme with trans-bronchial lung biopsy].

A 69-year-old woman was hospitalized several times because of asthma attacks. Laboratory data revealed an increase in eosinophils and elevation of serum IgE. Both chest radiographs and computed tomography showed fine nodular shadows in both lung fields. Tissue samples obtained by trans-bronchial lung biopsy (TBLB) revealed extra-vascular granuloma. The patient complained of numbness of the extremities and neuron conduction velocity was low. Based on these findings, Churg-Strauss syndrome was diagnosed. Prednisolone improved the patient's symptoms. Patients with this syndrome reportedly respond well if it is diagnosed and treated with corticosteroids early. Chest roentgenography reveals various abnormal shadows in patients with this syndrome. For early diagnosis, TBLB is helpful and comparatively safe. This case was unusual because extra-vascular granuloma was found by TBLB.

Aged↗
PubMed1994

[Retroviral infection as a putative pathogen for sarcoidosis].

Sarcoidosis is a granulomatous disorder of unknown etiology. Accumulated data suggest that one or several exogenous or altered self antigens participate in producing pathophysiological change in sarcoidosis. Recently, analysis of retroviruses such as HTLV-1 and HIV-1 revealed that these viruses would produce autoimmune disease like symptoms including interstitial lung disease like pulmonary manifestation. We hypothesized novel type retrovirus or retrovirus related antigens might be a putative pathogen for sarcoidosis. Syncytial cell formation or cytopathic effect was observed in 6 of 24 patients (25%) after coculture of sarcoid BALF cells with U937 cells. Five of 18 culture supernatant showed moderate reverse transcriptase activity. Expression of clone 4-1 env protein, one of the endogenous retroviral elements, was also observed in alveolar macrophages of sarcoidosis. These data encourages the further investigation of retrovirus as the pathogen of sarcoidosis.

Adult↗
PubMed1993

[A case of limited form of Wegener's granulomatosis without detection of anti-neutrophil cytoplasmic antibody].

A 52-year-old woman was admitted to our hospital because of high fever and productive cough. Her chest X-ray showed multiple cavitary nodules in both lungs. Although we suspected Wegner's granulomatosis (WG), anti-neutrophil cytoplasmic antibody (ANCA) was not detected in her serum. Finally, an open lung biopsy was performed, and the limited form of Wegener's granulomatosis was diagnosed. With cyclophosphamide and steroid treatment, she markedly improved. We conclude that in patients suspected of having WG, it is necessary to perform open lung biopsy regardless of the detection of ANCA.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1992

[Three cases of surgical treatment of dumbbell neurogenic tumor of the mediastinum--evaluation of intraspinal extension in cases without clinical symptoms].

Three cases of dumbbell neurogenic tumor of the posterior mediastinum are reported. None of these cases had any clinical symptoms, and an abnormal mass shadow of the mediastinum had been detected on routine chest roentgenogram. In these three cases, however, myelogram and/or CT findings were suggestive of tumor extension to the spinal canal in various degrees. Two tumors were resected in two-stage operations with combined thoracic and neurosurgical approaches, and the other case was treated by one-stage operation with the combined two approaches. All tumors were completely resectable without serious complications such as hemorrhage, leakage of spinal fluid, or neurologic deficit. Even in asymptomatic patients with neurogenic tumor located in the paravertebral region, it should be determined whether or not the tumor extends to the spinal canal through the intervertebral foramen, prior to planning the surgical procedure.

Adult↗
PubMed1992

[A case of recurrent pulmonary alveolar proteinosis treated by pulmonary lavage: were the remissions due to the natural course or due to the lavage?].

We report a 39-year-old male with pulmonary alveolar proteinosis. Although no abnormal shadows were seen on regular check-up chest roentgenogram one year previously, diffuse alveolar filling shadows were noted on admission, suggesting fairly acute progression of the disease. He was treated with bronchoalveolar lavage of each segment of both lungs by flexible fiberoptic bronchoscope under local anesthesia. Following this treatment, the shadows on X-ray film and shortness of breath resolved. Oxygen tension of arterial blood, pulmonary function, and serum CEA recovered to almost within normal ranges. The shadows deteriorated twice, but therapeutic lavage performed at the outpatient clinic was effective on each occasion. He thus received 3 series of bronchoalveolar lavage over a period of more than 3 years. We followed the clinical course of this patient for 6 years, and he remained well 3 years after the final treatment.

Adult↗
PubMed1991

Respiratory nicotine absorption in non-smoking females during passive smoking.

The aim of this study was to measure nicotine concentrations in inspired and expired air so as to learn more about respiratory (nasopharyngeal cavity and lung) nicotine absorption from inspired air and to estimate the nicotine intake during passive smoking. A total of 17 young non-smoking women were exposed to experimental passive smoking. Inspired and expired air was sucked at a constant rate into samplers filled with acid-treated diatomite (Uniport-S) to absorb nicotine in the air. Absorbed nicotine was assayed by gas chromatography. The range of nicotine concentration in the inspired air was 40-200 micrograms/m3. In this setting, 47 samples obtained from the 17 subjects were assayed. Nicotine absorption, which was calculated as [(nicotine concentration in inspired air-nicotine concentration in expired air)/nicotine concentration in inspired air] x 100, remained at 60%-80% (mean +/- SD, 71.3% +/- 10.2%) without being affected by the nicotine concentration in the inspired air. From this result, it was estimated that the average intake of nicotine was 0.026 mg/h in a group of non-smokers exposed in a room containing a nicotine concentration of 100 micrograms/m3, which is equivalent to fairly severe involuntary tobacco smoking. This is the first report on the estimation of respiratory nicotine absorption and nicotine intake during passive smoking based on the direct measurement of nicotine concentrations in both inspired and expired air.

Adolescent↗
PubMed1991

[An autopsy case of primary lung leiomyosarcoma].

We report autopsy findings for a case of leiomyosarcoma originating in the right lung in an 86-year-old man. We surveyed current literatures and compared the immunohistochemical results in the present case with those reported previously in Japan. The solid tumor measured 6 x 7 x 7 cm sized and was located in the right lung. Its cut-surface appeared grayish to yellowish and contained areas of hemorrhage and necrosis. The lungs contained scattered nodular lesions less than 2 cm in diameter. Metastatic lesions were also confirmed in other tissues such as the heart, pericardium, liver, spleen, left adrenal gland and thyroid. Microscopically, 14 mitoses were detected in every 10 high-power fields. An immunohistochemical study revealed positivity for smooth muscle myosin and actin, and negativity for CEA, and appeared to be important in differential diagnosis and determination of histogenetic type.

Aged↗
PubMed1988

On age-related norms of the visual field.

We prospectively studied the influence of age on visual fields obtained from 108 normal subjects (147 eyes) by using the Humphrey Field Analyzer (Program 30-2). Differential light sensitivity remained constant irrespective of age until the age of 35 to 44 years in the vast majority of test locations and then decreased linearly with age. The rate of linear decline differed at different test locations and failed to correlate with the eccentricity from the fixation, although its variance increased with the eccentricity. The mean sensitivity and the volume of the visual field were also constant until the age of 37.4 and 37.6 years, respectively.

Adolescent↗