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H Koba

Publications and source records attributed to H Koba.

At least 37 records · Page 2Linked to original sources
PubMed1995

Ontario's health-information service: a province-wide resource for patients.

An innovative service based in Toronto provides consumers with specialized yet understandable information about health care and health promotion. The Consumer Health Information Service gathers articles from medical journals, periodicals, health agencies, support groups, books and medical databases to provide people with better access to readily understandable health information. Much health-related information is available, says the chief librarian, but often people have trouble determining where it is.

Humans↗
PubMed1995

U of T Medical School uses multistep strategy to prevent sexual harassment.

The University of Toronto medical school is using a multistep strategy in an attempt to prevent sexual harassment among students and faculty members. A driving force behind the program is Dr. Miriam Rossi, who was recently appointed associate dean of student affairs. As well, the dean of medicine sent a notice to faculty members explaining that there will be zero tolerance "for any behaviour that can be construed to be sexual harassment."

Female↗
PubMed1995

[Radiological and pathological analysis of the distribution of centrilobular emphysema in the transverse plane of the lung].

The distribution of centrilobular emphysematous lesions in the transverse plane was studied with high-resolution CT (HRCT) images of inflated and fixed lungs obtained from 49 patients with centrilobular emphysema (CLE). The transaxial distribution of low attenuation areas (LAA) was assessed quantitatively on HRCT images obtained from 21 patients. LAA in the outer layer accounted for a significantly lower ratio of the lung parenchyma than did those in the inner layer. Macroscopic analysis of 31 lobes obtained from 28 patients with CLE was done by point counting. The inner layer had many more LAA than the outer layer. Bronchiolar lesions were examined under the microscope for their relation to the observed variations in distribution in CLE. No significant differences were found in the bronchiolar lesions between the inner and outer layers. These data show a characteristic distribution pattern of CLE in the transverse plane. They also suggest that the disparity in distribution of LAA between the inner and outer layers is not influenced by the grade of bronchiolar pathological lesions.

Female↗
PubMed1994

Soluble intercellular adhesion molecule-1 (ICAM-1) in sera and bronchoalveolar lavage fluid of patients with idiopathic pulmonary fibrosis and pulmonary sarcoidosis.

ICAM-1 plays an important role in inflammatory diseases. To assess level of soluble ICAM-1 in the circulation and inflamed lesions, we measured levels of soluble ICAM-1 in the circulation and bronchoalveolar lavage fluid (BALF) of patients with idiopathic pulmonary fibrosis (IPF) and with pulmonary sarcoidosis (PS) and of healthy volunteers (HV), and we also analysed ICAM-1 expression of BALF cells in some patients and HV. IPF patients had significantly higher levels of circulating ICAM-1 than HV, while PS patients did not. By contrast, significantly increased levels of BALF soluble ICAM-1 were found in PS patients compared with those of HV, but not in IPF patients. There were no significant differences in the proportions of ICAM-1+ BALF lymphocytes in IPF patients, PS patients and HV, whereas significantly increased proportions of ICAM-1+ pulmonary alveolar macrophages were found in PS patients compared with those of HV, but not in IPF patients. There was a significant positive correlation of BALF soluble ICAM-1 levels to BALF lymphocyte proportions in PS patients. Although the source of BALF soluble ICAM-1 is unclear, BALF soluble ICAM-1 appears to reflect the grade of local activity of sarcoidosis. An interesting discrepancy between soluble ICAM-1 levels in the circulation and BALF was found in IPF patients, and this might be an important clue to an understanding of this disorder.

Adolescent↗
PubMed1994

Chronic eosinophilic pneumonia progressing to lung fibrosis.

A 65 year old Japanese man was hospitalized with fever. Opacities distributed mainly in the subpleural regions were found on chest computed tomographic scan (CT), and these promptly cleared with corticosteroid therapy. Four years later, he presented with severe eosinophilia. Both chest X-ray and high resolution CT scan showed ground-glass opacities and honeycombing, suggesting lung fibrosis. A lung biopsy demonstrated intra-alveolar eosinophil infiltration, interstitial thickening with eosinophil infiltration, and a widely-distributed desquamative interstitial pneumonia-like reaction. With corticosteroid therapy, the ground-glass opacities decreased with a corresponding clinical improvement, although lung honeycombing and blood eosinophilia remained. In this case, circulating intercellular adhesion molecule-1 and circulating and bronchoalveolar lavage fluid eosinophil granule proteins were felt to be more effective markers for evaluating disease activity than the blood eosinophil number.

Aged↗
PubMed1994

[A case of Swyer-James syndrome--a morphological study with inflated fixed lung].

Morphological features of Swyer-James syndrome were studied in a specimen obtained during left pneumonectomy. A 67-year-old woman was admitted because her left lung was hyperlucent and contained a solitary nodule. Primary lung adenocarcinoma complicated with Swyer-James syndrome was diagnosed, and left pneumonectomy done. The left upper lobe was inflated and fixed for morphological study. The volume of the specimen was obviously lower than normal but the bronchial branching was normal. Macroscopically, the specimen had irregular bronchial walls, bronchiectatic changes, and dilation of distal air spaces, similar to panlobular emphysema. Microscopically, there was scarring in periarteriolar regions that suggested bronchiolitis obliterans, enlargement of distal airspaces, and an abnormally low number of capillaries. These findings suggest hypoplasia of the lung due to abnormal lung growth after birth.

Aged↗
PubMed1992

Circulating intercellular adhesion molecule-1 (ICAM-1) antigen in sera of patients with idiopathic pulmonary fibrosis.

Intercellular adhesion molecule-1 (ICAM-1), a member of immunoglobulin supergene family with a five-domain structure, is known to play an important role in inflammatory diseases. An ELISA was developed using two MoAbs against human ICAM-1 in order to detect the soluble shedding ICAM-1 antigen in sera. We measured levels of circulating ICAM-1 antigen in sera of patients with idiopathic pulmonary fibrosis (IPF), pulmonary sarcoidosis, hypersensitive pneumonitis, bacterial and mycoplasmal pneumonia, and inflammatory diseases of other organs. The results clearly demonstrated that IPF had significantly high levels of circulating ICAM-1 in sera as compared with other disorders or normal controls. Moreover, immunohistochemical analysis with MoAb against human ICAM-1 disclosed that in IPF, the expression of ICAM-1 was intensively enhanced on alveolar epithelial cells. These results suggest that ICAM-1 may contribute to the pathogenesis of IPF.

Adult↗
PubMed1992

[A case of systemic arterial supply to normal lung without sequestrated lung].

A 19-year-old man was admitted to our hospital because of bloody sputum. His chest radiograph showed funicular shadows adjacent to the descending aorta in the left lower lobe and absence of vascular structures in the lower portion of the left hilum. His chest CT showed increased vascularity and slightly increased parenchymal density in the left basal segments. No cystic lesions were observed on CT. Angiographic examinations revealed that the left basal segments were supplied by an aberrant artery arising from the thoracic aorta, instead of the pulmonary artery. Left lower lobectomy was performed. Gross findings at surgery and histological examination confirmed the diagnosis of systemic arterial supply to normal lung without sequestrated lung. The main histological findings of the specimen were hemorrhage in alveolar spaces and dilatation of vessels. These findings seemed to correspond to the CT findings. We consider that CT is useful for the diagnosis of this disease.

Adult↗
PubMed1992

[A case of chronic interstitial pneumonia with benign monoclonal gammopathy (IgM-k) and thrombocytopenia].

A 53-year-old woman was admitted on 13th October 1988 with symptoms of dry cough and shortness of breath persisting for 1 year. On physical examination, fine crackles were audible over her back. Chest X-ray showed bilateral reticulonodular shadows and collapse of the bilateral lower lobes. Chest CT showed patchy areas of increased density distributed predominantly in the subpleural zone. Laboratory data on admission showed thrombocytopenia, hypergammopathy (IgG, 2044 mg/dl; IgA, 286 mg/dl; IgM, 1645 mg/dl), and positive ANF. Further examinations demonstrated that anti-platelet and anti-centromere antibodies were positive in the serum, and the titer of PA-IgG was high (56 ng/10(7) platelets). Histopathological examination of the open lung biopsy demonstrated honeycombing and thickening of the alveolar walls, with slight infiltration of chronic inflammatory cells. These histopathological findings were comparable with usual interstitial pneumonia. We report a very rare case of chronic interstitial pneumonia complicated by benign monoclonal gammopathy and thrombocytopenia. Although it remains unclear, these abnormalities may have been caused by immunological mechanisms.

Autoantibodies↗
PubMed1991

[Qualitative assessment of centrilobular emphysema using computed tomography].

The ability of computed tomography (CT) in the qualitative assessment of centrilobular emphysema (CLE) was studied, with special reference to the morphological relationship between emphysematous change and relatively large bronchovascular bundle forming the margin of secondary pulmonary lobule. Three autopsied lobes with mild, moderate and severe CLE were fixed by the method of Heitzman. Then high resolution CT (HRCT) was applied to those inflation-fixed lobes, which allowed for direct one-to-one pathologic correlation. Furthermore, HRCT findings of these clinical cases with emphysema were analysed. Emphysematous change in CLE was observed as low-attenuation area (LAA) within the homogeneous background on Ct images. In mild and moderate cases, LAA's were round or oval in shape, however in severe case they were observed to be irregular in shape. The border between LAA and parenchyma was not clearly defined, however in severe case LAA was found to be bordered partially or rather subtotally by the bronchovascular bundle. In mild and moderate cases, LAA's were observed to be distant from relatively large bronchovascular bundle. On the other hand, in severe case, only a small amount of lung parenchyma was left between LAA and bronchovascular bundle. These findings correspond to morphologic characteristics of CLE, that is, the process of emphysematous change tends to take place in the center of the secondary lobule, and even if the lobe is severely destroyed, some portion of the peripheral acinus is still preserved at lobular margin. Thus, CT can help to identify the presence of CLE. Furthermore, CT scan analysis of severe grade emphysema may lead to the differentiation between CLE and panlobular emphysema.

Aged↗
PubMed1991

[CT findings in panacinar emphysema].

We analyzed the CT images (in vivo) of 5 lobes (right middle lobe, 1; left lower lobe, 1; right lower lobe, 3) with panacinar emphysema (PAE) obtained at autopsy or thoracotomy for solitary lung tumor. The lobes were inflation-fixed by the method of Heitzman and sliced axially for a CT-pathologic correlative study. One lobe with mild PAE had normal appearance on CT; however, the other four lobes with PAE demonstrated low-attenuation areas (LAAs) of various shapes and sizes on CT. LAAs were locally distributed on CT slices in one lobe, dominant in the inner zones in two lobes, and diffuse in one lobe. Relatively normal to diminished vasculature was observed within the LAAs of four lobes. These CT findings differed significantly from those of centriacinar emphysema (CAE) as reported in other studies. We conclude that CT is useful in the clinical diagnosis of PAE and its differentiation from CAE.

Aged↗
PubMed1990

[CT-pathologic correlative study of interstitial pneumonia].

A direct CT-pathologic correlative study of interstitial pneumonia was performed using inflated and fixed lungs. The specimens, which were obtained from 26 patients at the time of autopsy or during surgery, had pathologic findings of interstitial pneumonia (UIP and/or DAD). The specimens were fixed in distension and air dried. They were then scanned with a GE CT/T9800. HRCT images of the specimens could be correlated with two different types of pathologic processes. One was the chronic fibrotic change which was seen in the subpleural area of the specimens both from the autopsied and surgical cases, and the other was the acute alveolar change which was seen in the diffuse area of the specimens only from autopsied cases. HRCT images of the chronic fibrotic change showed nodular opacities, ring like opacities, increased density (high density), and air-bronchiologram in the subpleural area. These findings were correlated with patchy fibrotic lesions, honeycombing, mucus stasis in cysts of the honeycomb, and dilatation of the airways. HRCT images of the acute alveolar change showed mainly diffuse increased densities (hazy appearance and high density) and diffuse nodular opacities. These findings were correlated with a diffuse thickening of the alveolar walls, hyaline membranes in the alveoli and alveolar ducts, and their organization. Understanding of the difference between HRCT images of these chronic and acute pathologic processes is helpful for the evaluation of disease processes of interstitial pneumonia by HRCT. The abnormal patterns of HRCT images of the specimens were influenced by several technical factors of CT scanning, such as reconstruction algorithm, thickness of the slice, window level, and window width. It is, therefore, necessary to know the influence to HRCT images by these technical factors for a better understanding of HRCT images in interstitial pneumonia.

Adult↗
PubMed1990

[CT in eosinophilic granuloma of the lung].

We analyzed the chest CT findings in nine patients with biopsy-proven eosinophilic granuloma. Multiple cystic lesions with relatively thin walls seems characteristic of this disease. Small nodular lesions and increased density were observed in many cases. Pleural or subpleural lesions were found in all cases. In seven cases, the distribution of the lesions were predominantly in the upper or upper and middle lung fields. In the remaining two cases however, lesions were found homogeneously throughout the whole lung. In order to analyze the site of the lesions in the secondary pulmonary lobule, a specimen obtained from an open lung biopsy was inflated and fixed using fixative by Heitzman's method. Observation of the slices of the specimen by dissection microscope and their soft X-ray radiographs demonstrated that the lesion existed in the central area of acini. However, CT of the patient before open lung biopsy didn't showed centriacinar distribution. The disparity is because a certain number of lesions lobule is necessary to identify the centriacinar pattern by CT.

Adult↗
PubMed1989

[CT findings of bronchiolo-alveolar carcinoma with special reference to the lucencies within abnormal shadows].

Computed tomography (CT) was performed in the patients with bronchiolo-alveolar carcinoma. CT shows not only nodular shadows and pneumonia-like shadows that have been reported on plain radiographs, but also the lucencies of various sizes within those abnormal shadows. These findings seem to be characteristic of bronchiolo-alveolar carcinoma on CT. In addition, serial CT often demonstrates prominent changes of the lucencies, even when little change was observed in the outlines of the abnormal shadows. In regard to the progression of this disease, more attention should be paid to the lucencies as well as the outlines of abnormal shadows.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1989

[CT of the lung fibrosis in progressive systemic sclerosis].

The CT findings of the lung fibrosis in 5 patients with progressive systemic sclerosis (PSS) were analyzed. The main findings were high density with decrease of lung volume, air-bronchography in the high density area with decrease of lung volume, and ring shadows in various sizes in the periphery of the lung. The marked decrease of lung volume was a characteristic finding related to alveolar collapse by fibrosis.

Female↗
PubMed1989

[Idiopathic interstitial pneumonia; evaluation by high-resolution CT and pathologic correlation].

In order to identify and classify the basic CT appearances of interstitial pneumonia, radiologic -pathologic correlative study was performed using inflated and fixed lungs from autopsy and surgery. The patterns of the abnormalities on the CT images of interstitial pneumonia were classified into 7 categories. Important pathological changes which affected the CT images were alveolar collapse and airway dilatation. Based on the result of above study, we analyzed CT of 22 patients with IIP. The lesions which were classified into a hazy density, micronodular densities, confluence of various sized ring like shadows and subpleural bullous changes were frequently recognized together mostly in the periphery of the lung.

Aged↗