A 45-year-old man visited our clinic because of intermittent bloody sputum. The chest roentogenogram was normal, but the high-resolution computed tomography (HRCT) showed very small nodules and bronchiolitis adjacent to pleura in the upper right lung field. The bronchoscopic examination revealed blood-streaked bronchial secretion in the right upper lobe bronchus, and the cultures of the sputa and the bronchial washing specimen showed acid-fast bacilli identified as Mycobacterium intracellulare by DNA-DNA hybridization (DDH) method. This case was diagnosed as Mycobacterium intracellulare lung disease. The patient received isoniazid, levofloxacin, and clarithromycin for three years without clinical and bacteriological improvement. His hemoptysis and the number of colonies recovered from sputum cultures decreased without any medication later. The serial chest roentogenograms and HRCTs have showed no changes for 6 years after the diagnosis. This case may show some clues to elucidate the mechanism of the onset of Mycobacterium intracellulare lung disease without predisposing conditions.

Hemoptysis↗

PubMed2001

[Pulmonary nocardiosis associated with nephrotic syndrome].

A 70-year-old man treated for 6 months with prednisolone for nephrotic syndrome, was referred to our pulmonary division because of a nodule in the right lower lung field. Nocardia asteroides was isolated from the culture of the percutaneous lung aspiration, and the case was diagnosed as pulmonary nocardiosis. The lesion disappeared after 2 months of therapy with sulfamethoxazole/trimethoprim (1,600 mg/320 mg once a day). Though it had been given prophylactically (800 mg/160 mg twice a week) for the prevention of pneumocystis carinii pneumonitis.

Aged↗

PubMed2001

[A case of lung cancer in which FDG-PET was useful for preoperative diagnosis].

The patient was 48-year-old woman. The patient was referred to our hospital due to detection of an abnormal shadow on a chest X-ray image during a health checkup. The results of a CT scan morphologically suggested a benign tumor, but a diagnosis could not be made even after bronchoscopic cytology. FDG-PET revealed accumulation at the tumor site suggestive of malignancy, and an operation was performed. Prompt pathological examination showed that the tumor was adenocarcinoma, and right lower lobectomy and lymphnode dissection were performed. FDG-PET is thought to be useful for diagnosis in cases of lung tumor in which a preoperative diagnosis can not be established.

Adenocarcinoma↗

PubMed2001

[Evaluation of a combination chemotherapy with nedaplatin and 5-FU for oral cancers].

Nedaplatin (cis-diammine-glycolato platinum: CDGP) is a platinum compound with a molecular weight of 303.18 that was recently developed in Japan. There have been reports of the antineoplastic effects of Nedaplatin on cancers in the cranio-cervical region, lung, esophagus, urinary bladder, testis, ovary, and uterus. In this study, we performed combined therapy of CDGP and fluorouracil (5-FU) for 8 patients with oral cancers, and evaluated the results to elucidate the clinical effect and adverse side effects. The subjects were 8 patients with squamous cell carcinoma (5 males and 3 females aged 33-65 years). The primary carcinoma regions were the tongue in 5 patients, oral floor in 2 patients, and mandibular gingiva in 1 patient. The T-classification was T2 in 6 patients and T4 in 2 patients, and the clinical staging was Stage II in 5 patients, Stage III in 1 patient and Stage IV in 2 patients. We first administered 700 mg/m2 5-FU per day from day 1 to day 5 (total dose 3,500 mg/m2), then 90 mg/m2 CDGP on day 5. The clinical effect was evaluated as a partial response in all cases, showing a 100% success rate. The histopathological findings of resected tumors were evaluated by Ohboshi and Shimozato's classification. One patient was Grade IIA, 5 patients Grade IIB, and 2 patients Grade III. The adverse side effects were slight myelotoxicity, gagging, nausea, alopecia, and stomatitis less than Grade II. Although the oral cancers in this study were extroverted superficial ulcerative cancers, and the number of patients was low at 8, this combined therapy is considered useful and worth evaluating in further accumulated cases.

Adult↗

PubMed2001

[Wolman disease].

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Adult↗

PubMed2001

[Severe Klebsiella pneumonia improved by endotoxin adsorption and continuous hemodiafiltration].

A 57-year-old man who had past history of alcoholic hepatitis was admitted to our hospital because of fever, general malaise and dyspnea. Chest X-ray films and computed tomographic scans disclosed lobar pneumonia of the right upper lobe. Laboratory tests showed hypoxemia and renal dysfunction. Artificial ventilation, endotoxin adsorption (PMX) and continuous hemodiafiltration (CHDF) were started on the day after admission because of the appearance of progressive renal failure, hypotension and disturbance of consciousness. A diagnosis of septic multiple organ failure was made on the basis of a blood and sputum culture that revealed a K. pneumoniae infection. After the initiation of intensive therapy, the patient's general condition improved and artificial ventilation, PMX and CHDF were withdrawn. However, MRSA was isolated from sputum specimens and a lung abscess developed. In spite of vancomycin administration, the effect was limited. The patient underwent a right upper lobectomy and was discharged. The prognosis of bacteremic K. pneumoniae pneumonia in alcoholics is reported to be very poor. In our case, it is suggested that PMX and CHDF contributed to the improvement of the clinical course.

Adsorption↗

PubMed2001

[Cell surface display: a novel expression system of proteins].

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Animals↗

PubMed2001

[Safety studies on collagen viscoelastic substance as an auxiliary agent in anterior segment surgery--assays of anti-collagen antibodies in blood and residual concentration of collagen in the anterior chamber of rabbits].

PURPOSE: Alkali-soluble collagen solution was assessed as a possible viscoelastic substance in anterior segment surgery, in terms of its safe applicability by assaying antigenicity, disappearance rate of collagen from the anterior chamber, and histopathological effect on the corneal tissue. METHODS: The aqueous humor of rabbits was replaced with collagen solution three times. Then, follow-up clinical examinations with hand-slitlamp-microscopy, tonometry, pachymetry, and specular microscopy as well as ophthalmic histopathological examination were performed. Remaining collagen concentration in the aqueous humor at 1, 3, 5, 8, 24 and 72 hours after injection was determined to evaluate the disappearance rate of collagen from the aqueous humor with time. In vivo effects of chemical modification of collagen and buffer concentration on the corneal tissue were further studied by using transmission electron microscope (TEM) to find an optimum condition for collagen application. RESULTS: Neither anti-collagen antibody formation, nor inflammatory responses in the anterior segment and systemic symptoms were observed even after 3 injections of collagen solution, except for 1 case which showed corneal opacity. As much as 97.4% of the collagen injected into the anterior chamber disappeared from the eyeball. On the basis of TEM findings, succinylated collagen in diluted phosphate buffer seems to be superior to alkali soluble collagen in terms of corneal tissue protection. CONCLUSION: Collagen specifically prepared for this study showed no antigenecity and disappeared promptly from the anterior chamber. The optimal form of collagen in terms of corneal protection was discussed.

Animals↗

PubMed2001

[Liver transplantation for hepatocellular carcinoma].

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Biomarkers, Tumor↗

PubMed2001

Intratubal insemination with fresh semen in cats.

There have been few reports of artificial insemination using fresh feline semen because of difficulties in collecting semen. It has been shown previously that the number of spermatozoa required for fertilization of cats by intravaginal insemination and unilateral intrauterine horn insemination are 8.0 x 10(7) and 8.0 x 10(6), respectively. There have been no reports of intratubal insemination of cats. Therefore, a study was designed to determine the number of spermatozoa necessary to fertilize cats by intratubal insemination with fresh semen. Four male and 25 mixed breed female cats were used. Semen was collected using an artificial vagina. Insemination was performed by laparotomy 15-30 h after administration of 100 iu hCG on day 2 or 3 of spontaneous oestrus. Cats in which ovulation had not occurred at insemination received an additional 100 iu hCG after surgery. In intratubal insemination, four groups consisting of three, seven, eight and seven cats received 5.0 x 10(3), 5.0 x 10(5), 2.0 x 10(6) and 4.0 x 10(6) viable spermatozoa, respectively, into both uterine tubes at approximately 2 cm from the fimbriae tubae. The volume inseminated was 10-20 microliters. The semen volume was adjusted with egg yolk-Tris-fructose citrate. As a result of artificial insemination, none of the cats that received 5.0 x 10(3) or 5.0 x 10(5) spermatozoa were fertilized. However, fertilization was successful in two of eight animals (25.0%) that received 2.0 x 10(6) spermatozoa and in three of seven animals (42.9%) that received 4.0 x 10(6) spermatozoa. The number of kits was 1-4 (mean +/- SE: 2.4 x 0.6). These results indicate that although large numbers of spermatozoa were inseminated into the uterine tubes, the conception rate was low. The low rate of conception may have been due to problems in inducing capacitation of spermatozoa in the uterine tubes.

Animals↗

PubMed2001

[A case of sarcoidosis involving multiple organs that showed significant improvement as the serum KL-6 level fell after steroid therapy].

Pulmonary sarcoidosis was diagnosed by transbronchial lung biopsy in a 27-year old man admitted to our hospital in September 1996. In October 1999, bilateral parenchymal findings on chest radiography and the results of pulmonary function tests had significantly deteriorated compared with those of three years before. Since skin, heart, liver, and spleen lesions were also detected, this patient was treated with corticosteroids. The lung parenchymal lesions and the pulmonary function as well as the abnormal findings in other organs showed significantly improvement along with a decrease of the KL-6 level after steroid therapy.

Adult↗

PubMed2001

Age-related clinical and neurophysiologic characteristics of intractable epilepsy associated with cortical malformation.

PURPOSE: To elucidate the relationship between the characteristics of cortical malformation (CM) and those of associated epilepsy, and also to investigate the prognostic value of the clinical and magnetic resonance imaging (MRI) findings for the seizure and mental outcome. METHODS: We studied 41 patients with CM and epilepsy, and the patients were divided according to the age at onset of epilepsy into two groups: one group of 15 patients with very early onset before age 3 months, and the other group of 26 patients with onset at 3 months or later. Statistical relationship was examined between the types of dysplastic lesions demonstrated by MRI and the age at onset of epilepsy. The effects of the onset age and the features of CM on the outcome of seizures and mental or developmental state also were analyzed. RESULTS: The very early-onset epilepsy was related to the dysplastic patterns of reduced sulci and blurred cortical-subcortical junction, which suggested focal CM, whereas the later-onset epilepsy was related to polymicrogyria. The age at onset of epilepsy was related to the poor seizure outcome, and both the onset age and wide distribution of CM were related to severe retardation. CONCLUSIONS: The type of CM influences the expression of associated epilepsy, especially its age-related features. The age at onset of epilepsy plays an important role in the seizure and mental outcome.

Adolescent↗

PubMed2001

[A case of Japanese encephalitis presenting with unilateral lesions in diffusion-weighted MRI].

We report the findings of diffusion-weighted MRI (DWI) taken serially in a patient with Japanese encephalitis (JE). The patient was a 43-year-old woman presenting with headache, high fever and consciousness disturbance. The diagnosis of JE was made based on more than fourfold elevation of serum complement fixation antibody titer for JE virus in the convalescent phase of illness. The DWI on the second day of illness (Day-2) disclosed high-signal intensity lesions in the left thalamus, substantia nigra and frontal lobe cortex. The signal intensity of these lesions on the DWI increased on Day-3 but gradually decreased thereafter and normalized on Day-28. The improvement of the DWI findings was paralleled with that of the consciousness level and the cell number and neuron specific enolase concentration in the CSF, suggesting that DWI is useful for evaluation of the disease activity in JE. The lesions in the brain suffering from Japanese encephalitis are usually bilateral and diffuse. To our knowledge, this is the first report of JE presenting with unilateral lesions on MRI, of which phathomechanism remains to be elucidated.

Adult↗