Biomedical subjects
H Isonuma
Publications and source records attributed to H Isonuma.
Lung abscess: analysis of 66 cases from 1979 to 1991.
Sixty-six patients with bacterial lung abscess were treated between 1979 and 1991 in our hospital. Among these patients, death occurred in one of the 42 cases of community-acquired infection (mortality rate: 2.4%) and in 16 of the 24 cases of nosocomial infection (mortality rate: 66.7%). Of all 66 cases, 55 were culture-positive, and the etiologic agents isolated from 24 of the culture-positive cases were found to be anaerobic bacteria. The most common aerobes isolated from the foci were identified as Staphylococcus aureus, Klebsiella spp. and Pseudomonas aeruginosa, while the most common anaerobes were Bacteroides spp., Peptostreptococcus, Fusobacterium spp., microaerophilic Streptococcus and Veillonella. The mortality was higher in the cases with P. aeruginosa, Klebsiella spp. and Candida spp. than in those with other bacteria. The prognosis of lung abscess patients proved to depend on the presence of underlying diseases and on superinfection with aerobes.
Periodic fever compatible with familial Mediterranean fever.
A 55-year-old male presented with a recurrent fever of over 38 degrees C, occurring at irregular intervals 1-6 times a month with chest, back or abdominal pain. After admission to our hospital, we found the following characteristics: 1) the febrile attacks were accompanied by obvious inflammatory findings and pleuritis or peritonitis; 2) the patient's elder sister had a similar periodic fever; and 3) there were no apparent causative factors responsible for his symptoms. Therefore, we diagnosed this as a case compatible with familial Mediterranean fever. The febrile attacks have been completely suppressed by daily colchicine. This is the seventh case of familial Mediterranean fever reported in Japan.
[Asporogenic anaerobic empyema--clinical and bacteriological investigations of 31 patients with anaerobic empyema].
The author reviewed the records of 31 patients with asporogenic anaerobic empyema mostly seen in the wards of Internal Medicine, Juntendo University Hospital during the 27 years between 1961 and 1988, and obtained the following results. 1. There were 25 males and 8 females with an average age of 57.8 and 51.0 y/o (range, 25 to 79 y/o), respectively males more than forty years old occupied 74.2 percent of all cases. 28 patients (90%) had underlying conditions. 2. The cases of mixed infections with anaerobes and aerobes were only 22.6%. 3. The isolated bacteria were microaerophilic streptococcus, Bacteroides spp., Peptostreptococcus spp., Fusobacterium spp. etc. in this order. 4. There were no relationships between anaerobic infections with or without aerobes and putrid odor of pleural effusion. 5. Bacteroides spp. were isolated most in the group with putrid pleural effusion, however, they were not isolated in the group without putrid pleural effusion at all. This fact suggests that there is an intimate relationship between putrid odor and Bacteroides spp. 6. There was no deceased case which pleural effusion had been drained sufficiently with open or closed drainage. It suggests that sufficient drainage is the most important in therapeutic procedures of asporogenic anaerobic empyema.
[Eight cases of diphyllobothriasis].
Eight cases of diphyllobothriasis have been experienced in the Juntendo University Hospital. Seven of the 8 patients excreted tapeworm fragments. Eggs of Diphyllobothrium latum were found in the feces in 5 cases. One patient had a history of ingestion of raw trout (Sushi), and 2 raw salmon. One might have been infected in foreign countries, and 3 could not tell the source of infection. Bithoinol was administered orally to 7 patients. Four of the 7 excreted the worm and the scolex was recognized in three of the four. Neither recurrence nor abnormal findings have been recognized so far.
[Fluconazole treatment of systemic mycoses].
Efficacies of fluconazole, a new triazole antifungal agent, were evaluated in 11 cases of systemic mycoses (1 case each of candiduria, pulmonary cryptococcosis, pulmonary aspergillosis, pulmonary penicilliosis and suspected fungal pulmonary infection, and 3 cases each of candidemia and Candida endophthalmitis). The clinical efficacies were excellent or good in 8 out of 9 cases and poor in 1. Side effects observed were mild with 1 incident each of gastrointestinal symptom and reversible leukopenia. This drug appears to be promising in treatment of systemic mycoses.
Co-trimoxazole treatment of two fatal cases of Pneumocystis carinii pneumonia--changes in protozoan morphology and treatment method.
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