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Biomedical subjects

A Watanabe

Publications and source records attributed to A Watanabe.

At least 739 records · Page 41Linked to original sources
PubMed1989

[A case of bromocriptine-induced interstitial pneumonitis in an iron factory worker exposed to sand dust].

A 62-year-old male, was admitted on Oct. 7, 1987 because of productive cough and dyspnea. He worked for an iron factory, where pneumoconiosis was regarded as an occupational disease, for 40 years. No abnormal finding had been noted on his mass screening chest roentgenograms. He was well until three years ago when hypertension and Parkinsonism were noted. Since then he was treated with beta blockers, L-DOPA, amantadine and bromocriptine. Two weeks before admission, he suddenly complained of dyspnea and productive cough. His chest roentgenograms showed diffuse reticulonodular infiltration in both lung fields. The partial pressure of oxygen of the arterial blood was 65.9 Torr. The first transbronchial lung biopsy obtained from right B8 on Sept. 29, 1987 (before the admission) revealed some epithelioid granulomas and the second biopsy obtained from right B10 on Oct. 14, 1987 demonstrated bronchiolar edema and infiltration of inflammatory cells. Fibrotic changes associated with carbon dust between airways and vessels were also noted. Lymphocyte stimulation index by bromocriptine was 362%, and that by amantadine, 139%, L-DOPA, 150%, respectively. After ceasing the administration of bromocriptine, productive cough, dyspnea and the reticulonodular shadows diminished gradually. These findings strongly suggest that the interstitial pulmonary lesions are bromocriptine-induced interstitial pneumonitis. His occupational exposure to inorganic dust may be a predisposing factor.

Bromocriptine↗
PubMed1989

Lasting nutritional imbalance following abstinence in patients with alcoholic cirrhosis.

The dietary intake of eight alcoholic patients with liver cirrhosis following complete abstinence was compared with that of non-alcoholic cirrhotics. Protein and lipid amounts actually ingested were much lower, even following abstinence, in alcoholic cirrhotics than in non-alcoholic cirrhotics, suggesting that dietary customs of alcoholics with liver disease do not change easily. Therefore, dietary education is necessary for abstaining alcoholics and should be aggressively applied in the out-patient clinic.

Adult↗
PubMed1989

Liver fibrosis in obese patients with fatty livers.

Liver fibrosis was observed in non-alcoholic, non-diabetic obese patients with fatty liver. The extent of fibrosis was more severe in patients who were obese for a long time and had severe fatty deposition in the liver. Laboratory data were not useful for differentiating between fatty livers with and without liver fibrosis. The results suggested that fatty liver in obese patients should be treated by weight reduction in order to prevent the progression of liver fibrosis.

Adolescent↗
PubMed1989

[Nutritional requirements for oral Treponema].

Oral Treponema is still difficult to cultivate in vitro because of lacking of our knowledge about what they require for growth. The aim of this study was to find what were the nutritional requirements for them. Treponema denticola, T. vincentii, and T. socranskii were cultivated in various broths to seek which fractions of tryptone and rabbit serum, or serum proteins were stimulatory. Treponemal growth was assessed by turbidity readings. It was obvious that a weakly negative-charged peptide isolated from tryptone with molecular weight of about 800 daltons was stimulatory. However, further characterization of this peptide was failed, since the yield of the final fractions was too low to be identified with the conventional methods. The results on rabbit serum fractionated by a liquid chromatograph showed that serum proteins with molecular weight of 150,000 daltons were also stimulatory for T. denticola. Among the commercially available serum proteins, human and bovine ceruloplasmin gave good results. They could substitute for rabbit serum in the growth of T. denticola and T. vincentii.

Animals↗
PubMed1989

[A case of successful repair of a left subclavian arterial aneurysm ruptured into the esophagus--review of 89 cases in Japan].

This report concerns a case of a left arteriosclerotic subclavian arterial aneurysm ruptured into esophagus. A 61-year-old man who complained of fever, dyspnea, and dysphagia was diagnosed by chest X-ray, selective left subclavian arteriogram, and chest CT. Because he vomited a large amount of blood before an operation, we suspected that the aneurysm had ruptured into the esophagus, and therefore performed an emergency operation. The operative procedure consisted of exposing the aneurysm through a median sternotomy incision with the addition of a left supraclavicular incision, proximal and distal ligation, and reconstruction of blood flow by an aorto-left subclavian artery bypass with a Gore-tex prosthetic graft; however the aneurysm was not resected because of adhesion to the surrounding tissues. The post-operative course was uneventful and the patient is now normal and back at work, 2 years after the operation. Subclavian arterial aneurysms are relatively rare among peripheral arterial aneurysms. The common causes of subclavian aneurysms are arteriosclerosis (18%), trauma (14.6%), non specific inflammation (13.5%), and thoracic outlet syndrome (11%). Of the only 15 ruptures in 89 cases that have been reported in Japan, none have ruptured into the esophagus. Subclavian artery aneurysms represent a risk of rupture or peripheral circulatory failure, and consequently, should be considered for surgical treatment.

Aneurysm↗
PubMed1989

Thoracoabdominal approach for cure of patients with an adenocarcinoma in the upper third of the stomach.

In 134 patients with an adenocarcinoma in the upper third of the stomach and involving the lower esophagus, the authors retrospectively assessed the significance of a thoracoabdominal approach (TAA). Nineteen (48.7%) of 39 with TAA had major postoperative complications, while 25 (26.3%) of 95 with the abdominal approach (AA) had similar complications (P less than 0.02). The most frequent complication was anastomotic leakage. In the case of TAA, seven (18.0%) experienced this, and nine (9.5%) did so after AA. However, deaths resulting from complications were few for both TAA (five, or 12.8% and AA nine, or 9.5%). There was one (2.6%) patient with histologically positive cancer cells at the proximal stump of the resected specimen in patients with TAA, while there were seven (7.7%) such patients with AA. In the histologically curative cases without palliative factors, patients with TAA had a significantly better prognosis than did those with AA (P less than 0.05). In the histologically noncurative cases and in cases with palliative factors, the prognosis was poor for both TAA and AA patients. These results suggest that the surgeon should perform the TAA in order to obtain tumor-free margins at the proximal stump and a better prognosis in patients without palliative factors, while the surgeon need not consider doing the TAA in patients with palliative factors.

Adenocarcinoma↗
PubMed1989

[Acute myelogenous leukemia accompanied by HTLV-I associated myelopathy (HAM) caused by blood transfusion].

A case of AML accompanied by HTLV-I associated myelopathy (HAM) is reported. A 37-year-old woman was admitted to our hospital in April 1985 because of severe anemia, general malaise and fever. On admission, anemia, thrombocytopenia and leukocytosis consisting of 32% myeloblasts and 6% promyelocytes were noted. A bone marrow study revealed marked myeloid hyperplasia, and a diagnosis of acute myelogenous leukemia (M2) was made. In order to improve the patient's severe anemia and thrombocytopenia, a large amount of blood transfusion was applied at once. Thereafter BHAC-DMP therapy was commenced resulting in complete remission 3 months after initiating chemotherapy. Hematological improvement has continued (as of May 1988). In June 1986 the patient showed a gait disturbance of slowly progressive course. Neurological examination revealed hyperactive knee and ankle jerks with a positive Babinski's sign, and foot clonus were also noted bilaterally. Sphincter impairment was detected. A CSF sample contained slight pleocytosis with some abnormal lymphocytes similar to those found in adult T cell leukemia. Antibodies to HTLV-I were found in the CSF and serum by EIA method. According to these findings we diagnosed the patient's illness as HAM, referring to the new clinical entity named by Osame. This patient had undergone a blood transfusion 14 months before the onset of this myelopathy, therefore the transmission of exogenous antigens through blood transfusion may be the cause of HAM. Corticosteroid pulse treatment was administered and striking improvements countering gait disturbance resulted in this patient.

Adult↗
PubMed1989

[A case of primary pulmonary sporotrichosis].

We report the first case of primary pulmonary sporotrichosis in Japan. A 53-year-old man was admitted to our hospital for further examination of the abnormal shadows on chest X-ray film. Six months before admission, he was admitted to another hospital because of alcoholic liver disease and diabetes mellitus. Since the initial chest film showed cavities with infiltration in the left upper lung field, he was treated with antituberculous drugs despite negative sputum cultures for mycobacterium. In spite of the medication, his chest X-ray film revealed another cavitary lesion, so he was referred to our hospital. He had been asymptomatic during this period. Chest X-ray on admission disclosed multiple cavities in the left upper lobe and a cavity in the right lower lobe. Repeated sputum specimens, bronchial washings and brushings for cytology and cultures were all negative. In an attempt to clarify the pathogen, percutaneous lung aspiration (PLA) was performed. The PLA sample yielded a positive culture of Sporothrix shenckii. After the diagnosis, S. schenckii was also cultured from sputa. A sporothrix skin test and yeast agglutination test for S. schenckii were positive. In the absence of a history for skin lesion, the patient was diagnosed as a primary pulmonary sporotrichosis. As iodide therapy was ineffective, he was started on a regimen of intravenous amphotericin B. However his renal function progressively deteriorated, so amphotericin B was discontinued. Now he receives miconazole intravenously and is still under careful observation. As far as we know, this is the first report of primary pulmonary sporotrichosis in Japan. The possibility of sporotrichosis should be considered in any cases of undiagnosed cavitary lung diseases.

Hemagglutination Tests↗
PubMed1989

[Quantitative analysis of myocardial revascularization on left ventricular diastolic function].

To evaluate the effects of myocardial revascularization on left ventricular diastolic function, we studied three groups of subjects. Group I consisted of 10 patients without any previous myocardial infarction. Group II consisted of 10 patients with previous myocardial infarction. The control group consisted of 8 normal subjects, all with no evidence of cardiac disease as determined by cardiac catheterization. Left ventricular diastolic function was assessed by maximum negative dp/dt, constant T, diastolic compliance and 1/3 fractional filling before and after surgical revascularization. (1) Constant T, maximum negative dp/dt and diastolic compliance: There was no significant difference among groups I, II and the control group preoperatively, and the variables were not improved postoperatively. (2) 1/3 fractional filling: 1/3 fractional fillings in groups I and II were significantly lower (p less than 0.05, p less than 0.01) than the control group preoperatively, and it was significantly improved in group I, but unchanged in group II postoperatively. In conclusion, myocardial revascularization improves left ventricular diastolic function in the patients without previous myocardial infarction. The effects of myocardial revascularization, however, in the patients with prior myocardial infarction do not bring about an enhancement of left ventricular diastolic function.

Adult↗
PubMed1989

[Clinical studies on cefpodoxime proxetil in the pediatric fields].

Cefpodoxime proxetil (CPDX-PR, CS-807) was given orally to 18 children with acute bacterial infections including 10 with acute tonsillitis, 3 with acute bronchitis, 1 with pneumonia, 3 with staphylococcal scalded skin syndrome and 1 with infectious impetigo. Daily dosages per kg bodyweight ranging from 7.5 to 18 mg were given in 2 or 3 divided doses per day for 5 to 15 days. Clinical responses were excellent in 3 (16.7%), good in 11 (61.1%), fair in 4 (22.2%) and poor in 0 (0%), with an overall efficacy rate of 77.8%. Good bacteriological responses were obtained in 6 out of the 7 cases from which pathogens were identified. No side effect was observed. The above results suggest that CPDX-PR is a useful new oral cephalosporin derivative for the treatment of bacterial infections in children.

Acute Disease↗
PubMed1989

[Laboratory and clinical studies on cefteram pivoxil in pediatric field].

Pharmacokinetic and clinical studies of cefteram pivoxil (CFTM-PI, T-2588) fine granules in children were performed and the following results were obtained. 1. Peak serum concentrations in 4 children given orally a dose of 3 mg/kg and 2 children given orally a dose of 6 mg/kg after meal were reached in 3 to 4 hours and the concentration curves were dependent on dosage levels. The urinary recovery rates up to 8 hours were 29.7% in children given a dose of 3 mg/kg and 29.7% in children given a dose of 6 mg/kg. 2. Clinical efficacies were evaluated in 38 patients with bacterial infections. Twenty seven patients were given each doses of 3 mg/kg in 3 times a day and other 11 patients each doses of 6 mg/kg in 3 times. Clinical effects of CFTM-PI were excellent in 18, good in 19, fair in 1 case, hence the overall clinical efficacy rate was 97.4%. 3. Bacteriologically, 24 strains of causative organisms were isolated. The overall bacteriological eradication rate was 81.8%. Antimicrobial activities were excellent especially against Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae. 4. As for the side effects, slight loose stools were observed in 2 cases, and in laboratory tests, elevations of GOT and GPT were observed in 1 case and an elevation of eosinophil was observed in 1 case. But no one needed any treatment. 5. CFTM-PI is a useful and safe oral antibiotic for the treatment of bacterial infections in pediatrics.

Bacterial Infections↗
PubMed1989

[Transient myeloproliferative disorder (TMD) with transiently increased tetrasomy-21 cells in a phenotypically normal newborn].

We reported a case of TMD with transient increase of tetrasomy-21 cells in a phenotypically normal newborn. The patient was admitted to the St. Marianna University Hospital due to hepatosplenomegaly on the 7th days after birth. Hematological findings on admission revealed remarkable leukocytosis (168,300/microliters) with 79% blasts. Immunological studies of the blasts showed a positive reaction for platelet associated antigens, KOR-P77, AN50, TP80 and a pan-T antigen, TP40. Cytochemically blasts were strongly positive for acid phosphatase, positive for alpha NAE and weakly positive for PAS. The platelet peroxidase reaction was observed in rough endoplasmic reticulum of blast cells. Both immunological and cytochemical findings suggested that the blasts were of megakaryocyte lineage. Chromosomal analysis of the blasts showed 48, XX, + 21, +21 (21 tetrasomy). After chemotherapy with PSL and 6MP, bone marrow showed a complete remission. But we thought it was spontaneous remission because PSL and 6MP were not effective to acute megakaryocytic leukemia (AMKL). Bone marrow cells were karyotypically normal on the 67th day of life when abnormal blasts were not observed in the bone marrow.

Chromosome Aberrations↗
PubMed1989

[Two cases of Hermansky-Pudlak syndrome with interstitial pneumonia].

Two cases of Hermansky-Pudlak syndrome with interstitial pneumonia were reported. Both patients had evidence of pulmonary involvement characterized by diffuse bilateral infiltrates. They had oculocutaneous albinism. Case 1 was a 55 year-old female who had a history of easy bruising. Her two sisters were albino and had died of pulmonary fibrosis. One of them was diagnosed as Hermansky-Pudlak syndrome on autopsy. Bone marrow aspirate disclosed typical macrophages with ceroid-like pigment. Transbronchial lung biopsy showed alveolar wall thickening. Lumi-aggregometer showed a decrease of platelet aggregation and an absence of ATP release. Case 2 was a 43 year-old female and had a bleeding tendency during a surgical procedure. Lumi-aggregometer showed normal platelet aggregation but an absence of ATP release. BALF analysis did not disclose macrophages with ceroid-like pigment.

Adult↗
PubMed1989

[A case of breast cancer with multiple metastases to the lung and bone responding well to cisplatin and vindesine].

A case of recurrent breast cancer with metastases to the lung and bone responding well to cisplatin and vindesine in a 45-year-old woman was reported. She had a radical mastectomy for the right breast cancer (pT2N0M0) at 28 years old. She was well until March 1985, when right iliac bone pain appeared. Osteolytic changes were noted on her pelvic roentgenogram. A biopsy obtained from the right iliac bone revealed metastatic adenocarcinoma. She was admitted to our hospital in December 1985 because of chest pain and swelling of the left axillary lymph nodes. Lymph nodes also showed metastatic adenocarcinoma with positive estrogen receptor. Her chest roentgenogram demonstrated a coin lesion in the left hilum and also left pleural effusion. Cytology of the effusion revealed adenocarcinoma. She was first treated with Adriamycin, 5-FU and Cyclophosphamide, but no significant response was noted. But, after two courses of chemotherapy containing cisplatin (80 mg/m2) and vindesine (3 mg/m2), the coin lesion of the lung and pleural effusion disappeared. The osteolytic bone change of the pelvic bone also improved. The serum CEA level decreased from 34.2 ng/ml to 4.2 ng/ml. These results suggest that cisplatin and vindesine were effective for lung and bone cancers metastatic from adenocarcinoma of the breast.

Adenocarcinoma↗