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Akihiko Kawana

Publications and source records attributed to Akihiko Kawana.

At least 19 recordsLinked to original sources
PubMed2006

Pneumoconiosis associated with an esophageal ulcer and uptake revealed in FDGPET.

A 76-year-old man with a past history of pneumoconiosis visited the Department of Gastroenterology in our hospital suffering from dysphagia. Gastroscopy revealed an esophageal ulcer on the top of a torus lesion. Chest computed tomography (CT) revealed it was caused by a swollen lymph node in the mediastinum. Squamous cell carcinoma related antigen (SCC) was elevated to 1.8 ng/ml. To rule out malignancy, we performed fluorine-18 deoxyglucose positron emission tomography (FDGPET) which revealed a significantly increased uptake in a nodular lesion in the right upper lobe and mediastinal lymph nodes. Biopsy and cytology of the nodular lesion revealed only pneumoconiosis. We must be careful when we interpret the findings of FDGPET in pneumoconiosis patients.

Aged↗
PubMed2006

[A case of severe falciparum malaria successfully treated with intravenous artesunate and continuous hemodiafiltration].

We report a 54-year-old Japanese man who contracted severe falciparum malaria after visiting West African countries. The patient presented with Plasmodium falciparum parasitemia of 10% on admission and was successfully treated with intravenous artesunate combined with continuous hemodiafiltration. We found that intravenous artesunate had excellent antimalarial activity with rapid parasite clearance and that few adverse effects were observed compared to those reported for intravenous quinine treatment. Supportive therapy was indispensable for saving the life of the patient. Few cases of intravenous artesunate treatment are reported in Japan because the drug has not been legally registered. We wish to emphasize the efficacy of intravenous artesunate with general supportive therapy in the treatment of possible imported severe malaria patients in Japanese medical settings.

Antimalarials↗
PubMed2006

[Case of cavitary coccidioidomycosis with fungus balls in the apices of both lungs].

Pulmonary cavitary coccidioidomycosis with a fungus ball was observed in a immunocompetent case. A 32-year-old Japanese man visited Arizona to play golf. After 1 month he consulted a local hospital complaining of a prolonged cough and hematopysis. The laboratory examination revealed eosinophillia and chest radiograph showed 2 cavitary lesions, surrounded by small nodules in the apices of both lungs. Pulmonary tuberculosis was suspected and treated with 4 antituberculosis drugs for 3 months. However, the cavities enlarged and he was admitted to our hospital for further examination and treatment. Transbronchial lung biopsy was performed and serologically, bacteriologically and histologically a diagnosis of chronic coccidioidmycosis was made. It is very rare for fungus ball formation and coexistence of spherules and hyphae of Coccidioides immitis to be seen. Fluconazole was temporarily effective, causing cavities to shrink and eosinophilia to decrease, however Amphotericin B needed to be used later. Eosinophilia was closely related to the severity of the disease gravity.

Adult↗
PubMed2006

"Syndromic surveillance within a hospital" for the early detection of a nosocomial outbreak of acute respiratory infection.

We have performed intra-hospital syndromic surveillance to rapidly detect nosocomial acute respiratory infection outbreaks in both inpatients and health care workers in a hospital. Syndromic surveillance allows the rapid detection of sudden outbreaks, including infections caused by unknown pathogens. This approach depends on the identification of specific "symptoms" as signs of a possible outbreak, with no need for specific diagnoses. Moreover, syndromic surveillance is quick, easy, and inexpensive. Nosocomial infection surveillance is usually performed on inpatients only. However, during the outbreaks of SARS and seasonal influenza, for example, many hospital personnel were infected. In cases of this kind, in order to quickly detect the prevalence of such infections, a surveillance system that includes hospital personnel is essential. This surveillance is promising as a strategy to prepare for re-outbreaks of SARS and the emergence of novel influenza pandemics.

Acute Disease↗
PubMed2005

Trial surveillance of cases with acute respiratory symptoms at IMCJ Hospital.

We have developed a surveillance system that can detect a severe acute respiratory syndrome (SARS) outbreak in a hospital as quickly as possible using the "SARS alert" strategy proposed by the World Health Organization (WHO). Our research examined hospital staff and in-patients during the winter of 2003/2004. We defined patients with a fever of over 38 degrees C and respiratory symptoms as "cases with acute respiratory symptoms." During the study period, 215 such cases (78% in-patients; 22% hospital staff members) were reported. A rapid diagnostic test for influenza was performed on 131 individuals, with 52 having positive results. There were no cases fulfilling the definition of SARS provided by the WHO in their SARS alert. The present surveillance system will be of use in the early detection of a SARS epidemic in a hospital as well as in early detection of similar illnesses accompanied by acute respiratory symptoms, such as influenza.

Adolescent↗
PubMed2005

[Impact of the change in criteria for hospital discharge of patients with tuberculosis based on the duration of hospitalization].

OBJECTIVES: The criteria for discharge from TB ward was changed from sputum culture negative to smear negative since January 2003 and the duration of hospitalization and the applicability of each criteria were analyzed. METHODS: Cases hospitalized from Jan. to Dec. 2003 (Group I) were compared with those hospitalized from Jan. 2000 to Dec. 2002 (Group II). In group I, we investigated which criteria was applied for each case. RESULTS: Shifting criteria from culture negative to smear negative, the median duration of hospitalization was shortened from 83 to 70 days, in particular in 20s, 30s and 70s. No effect however were found in patients with initially high grade excreter of AFB or extensive cavitary lesions. Although 44% of patients were discharged according to smear conversion to negative, this criteria could not be applied in 17% due to some reasons. CONCLUSIONS: Conversion to culture negative has been conventionally used for discharge criteria in Japan considering not only contagiousness of the disease but to maintain patients adherence to treatment. After the introduction of new criteria to shorten the hospitalization periods, Japanese style DOTS after discharge would be more important to maintain patients adherence to treatment. We will continue to evaluate the treatment completion rate.

Adult↗
PubMed2005

[Clinical and epidemiological review of SARS].

Severe acute respiratory syndrome (SARS) was caused by a previously unrecognized new type coronavirus. The disease probably first emerged in Guangdong China around November 2002, and it spread from there first to countries in Southeast Asia, and finally throughout the world. During the outbreak, more than 8,000 cases and about 800 deaths had been reported. The first sign of illness in most cases of SARS is fever, headache, malaise, or myalgia, and then majority of patients present severe atypical pneumonia. It appeared that disease spread most often in hospitals in health care workers, and patients and among family members. Given the severity of SARS, clinicians throughout the world empirically treated most patients with corticosteroids and ribavirin.

Humans↗
PubMed2004

[SARS].

Explore the source record for details and available documents.

Animals↗
PubMed2004

ACE1 polymorphism and progression of SARS.

We have hypothesized that genetic predisposition influences the progression of SARS. Angiotensin converting enzyme (ACE1) insertion/deletion (I/D) polymorphism was previously reported to show association with the adult respiratory distress syndrome, which is also thought to play a key role in damaging the lung tissues in SARS cases. This time, the polymorphism was genotyped in 44 Vietnamese SARS cases, with 103 healthy controls who had had a contact with the SARS patients and 50 controls without any contact history. SARS cases were divided into either non-hypoxemic or hypoxemic groups. Despite the small sample size, the frequency of the D allele was significantly higher in the hypoxemic group than in the non-hypoxemic group (p=0.013), whereas there was no significant difference between the SARS cases and controls, irrespective of a contact history. ACE1 might be one of the candidate genes that influence the progression of pneumonia in SARS.

Disease Progression↗
PubMed2003

[Usefulness of directly observed therapy (DOT) during hospitalization as DOTS in Japanese style].

Many patients with smear positive tuberculosis were hospitalized during the initial phase of chemotherapy but DOT was not applied to patients with tuberculosis in Japan. We tried randomized clinical study to evaluate the usefulness of DOT during admission. 135 culture positive TB patients were administered by DOT and 124 culture positive TB patients were self-administered during admission. There was no significant difference between 2 groups in the clinical background factors, treatment and the incidence of adverse reactions. Treatment completion rate was 94.1% in DOT group and 87.9% in non-DOT group. Default rate was significantly lower in DOT group (4.4%) than in non-DOT group (11.3%). We concluded that "DOT during admission" was useful to improve the outcome of chemotherapy for tuberculosis and it is preferable to apply DOT throughout treatment course for patients with tuberculosis in Japan.

Adult↗
PubMed2003

[Infection control measures for SARS during epidemics of influenza].

Outbreaks of SARS affected more than 8,400 people, and caused more than 900 deaths worldwide but came to an end in July, 2003. However, the recurrence of SARS epidemics in winter is possible. The symptoms of SARS resemble those of influenza. Therefore, a simultaneous epidemic of both may cause great confusion. We compared clinical symptoms between SARS and influenza and discussed infection-control measures. Since both SARS and influenza mainly spread by droplet infection, preventive measures against this route are important. In addition, vaccination for influenza and the use of rapid diagnosis kits for influenza are recommended.

Communicable Disease Control↗
PubMed2002

[The usefulness of 11C-Choline-positron emission tomography in the diagnosis of sclerosing hemangioma of the lung--a case report].

A 64-year-old woman was admitted to our hospital for further examination of an abnormal shadow in the left lung, that had grown slowly for 9 years. Bronchial brushing cytology was performed under bronchoscopy, but was negative for malignancy and for other significant findings. 11C-Choline-positron emission tomography (11C-Choline-PET) showed medium-level uptake in the mass lesion in the S 6 lobe of the left lung, but 18F-fluorodeoxyglucose-positron emission tomography (18FDG-PET) did not yield any such result. These findings suggested the presence of a slowly growing benign tumor, or a neoplastic disease, such as a potentially malignant tumor or a low-grade malignancy. To arrive at a diagnosis, a left partial lobectomy was performed on January 29, 2001. The microscopic findings of this mass lesion showed a solid, hemorrhagic pattern; papillary projections into spaces covered or lined by cuboidal cells, and sheets of round to polygonal cells. The histological diagnosis of this tumor was a sclerosing hemangioma. Recently, 18FDG-PET has been proven to be a clinically useful tool for the detection and staging of malignant tumors, and the follow-up of malignant diseases after treatment; while 11C-choline was recently reported to be a new PET tracer used to visualize various malignancies. The uptake of 11C-choline in tumors represents the rate of tumor cell duplication. It is suggested that 11C-choline-PET may be useful in the diagnosis of sclerosing hemangioma, as in this case.

Carbon Radioisotopes↗