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Biomedical subjects

K Onuma

Publications and source records attributed to K Onuma.

33 records · Page 2Linked to original sources

Amalgam allergy associated with exacerbation of aspirin-intolerant asthma.

BACKGROUND: Aspirin-intolerant asthma can be induced not only by acidic analgesics (including acetylsalicylic acid), which effectively inhibit cyclo-oxygenase, but also by cross-reactivity with paraben, and other chemical additives. OBJECTIVE: We examined whether amalgam allergy is involved in the pathogenesis of a aspirin-intolerant asthma. METHODS: We present the first case of aspirin-intolerant asthma that improved after the removal of dental amalgam. In addition, we performed both the methacholine provocation testing and sulpyrine provocation testing before and after the removal of dental amalgam. RESULTS: In addition, the methacholine concentration causing a 20% fall in FEV1 in provocation tests rose significantly, though hypersensitivity to analgesics evaluated with sulpyrine provocation testing did not decrease. These results suggest that amalgam sensitization is involved in bronchial hyperresponsiveness in aspirin-intolerant asthma. CONCLUSION: Sensitivity to amalgam may cause exacerbation of aspirin-intolerant asthma in some patients. To the best of our knowledge, this is the first case report of amalgam allergy associated with aspirin-intolerant asthma.

Adult↗

Obesity, weight gain and risk of colon adenomas in Japanese men.

Obesity has been related to increased risk of colon cancer or adenomas, but the epidemiologic findings are not entirely consistent. We examined the relation of not only body mass index (BMI) but also waist-to-hip ratio (WHR) and weight gain to colon adenoma risk in men who received a preretirement health examination at the Japan Self Defense Forces (SDF) Fukuoka and Kumamoto Hospitals during the period from 1995 to 1996. In the series of 803 men at age 47-55 years, 189 cases of colon adenomas and 226 controls with normal total colonoscopy were identified. Weight at 10 years before was ascertained by referring to the recorded data. After allowance for hospital, rank in the SDF, smoking and alcohol use, weight gain over the past 10 years was significantly associated with increased risk of colon adenomas (odds ratio for > or = 6 kg versus < or =-2 kg = 2.2; 95% confidence interval 1.0-4.8). High BMI and high WHR were each associated with increased risk, but only WHR was related to the risk independently of weight gain. In particular, weight gain accompanied with a high WHR was associated with a significant increase in the risk. Men with high physical activity tended to have lower risk. Associations with obesity-related variables and physical activity were not materially differential as regards the location and size of adenoma. The findings indicate that weight gain in middle age leading to abdominal obesity increases the risk of colon adenomas, and consequently of colon cancer.

Adenoma↗

Effect of acyclovir on bronchoconstriction and urinary leukotriene E4 excretion in aspirin-induced asthma.

BACKGROUND: Acyclovir (9-[2-hydroxyethoxymethyl] guanine), an inhibitor of the DNA polymerase of the herpes virus, has been reported to exhibit pharmacologic activity other than antiviral activity, including antiasthmatic effects. OBJECTIVE: This study was designed to investigate the protective effect of acyclovir on airway responsiveness to the sulpyrine provocation test and to investigate whether this protective activity is associated with a reduction in aspirin-induced excretion of urinary leukotriene E4 (u-LTE4 ), a marker of cysteinyl leukotriene (LT) overproduction that participates in the pathogenesis of aspirin-induced asthma. METHODS: We assessed the effects of pretreatment with acyclovir on bronchoconstriction precipitated by inhalation of sulpyrine in 16 adult patients with mild or moderate aspirin-induced asthma; those who were in stable clinical condition and were hyperresponsive to the sulpyrine provocation test were allocated to this study. A double-blind, randomized, cross-over design was used. u-LTE4 was measured by a combined reverse-phase HPLC enzyme immunoassay. RESULTS: Acyclovir protects against aspirin-induced attacks of asthma through mechanisms unrelated to its bronchodilator property but related to the improvement of bronchial hypersensitivity to sulpyrine; protection was nearly complete in all patients (P <.0001). By contrast, after acyclovir, the maximum level of u-LTE4 in patients was significantly lower than that in control subjects (P <. 01). CONCLUSION: Our results suggest that acyclovir is not only an antiviral drug but also an inhibitor of analgesic-induced bronchoconstriction, probably acting by inhibiting the release of cysteinyl LTs.

Acyclovir↗

Cromolyn sodium prevents bronchoconstriction and urinary LTE4 excretion in aspirin-induced asthma.

BACKGROUND: Inhalation of cromolyn sodium protects against sulpyrine-induced bronchoconstriction and prevents urinary leukotriene E4 (u-LTE4) excretion in aspirin-induced asthma. OBJECTIVE: This study was designed to investigate the protective effect of cromolyn sodium on airway responsiveness to the sulpyrine provocation test, and to investigate whether this protective activity is associated with a reduction in aspirin-induced urinary excretion of LTE4, a marker of the cysteinyl leukotriene overproduction that participates in the pathogenesis of aspirin-induced asthma. METHODS: We evaluated the effects of pretreatment with cromolyn sodium on bronchoconstriction precipitated by inhalation of sulpyrine in ten adult patients with mild aspirin-induced asthma. Those who were in stable clinical condition and were hyperresponsive to sulpyrine provocation test were allocated to this study. Urinary leukotriene E4 was measured using combined reverse phase high performance liquid chromatography (rp-HPLC)/enzyme immunoassay. RESULTS: Inhaled cromolyn sodium protects against aspirin-induced attacks of asthma through mechanisms not related to the bronchodilator property, but related to the improvement of the bronchial hypersensitivity, almost completely in all patients (P < .001). By contrast, after cromolyn sodium the maximum level of u-LTE4 was significantly lower than control (P < .05). CONCLUSION: Our results suggest for the first time that inhaled cromolyn sodium is one of the most useful inhibitors of aspirin-induced bronchoconstriction, probably acting by inhibiting the release of cysteinyl leukotrienes, and possibly other chemical mediators, by bronchial inflammatory cells.

Administration, Inhalation↗

Mechanical properties of hydroxyapatite and OH-carbonated hydroxyapatite single crystals.

Single-crystal hydroxyapatite and OH-carbonated hydroxyapatite have bending strength much higher than that of dense hydroxyapatite ceramic, indicating potential applicability to a load-bearing biomaterial. However, the effects of carbonate on the strength are less clear. The objective of the present study was to determine the bending strength and Young's modulus of these single crystals with carbonate contents from 0 to 0.62 in CO2 wt%. Three-point bending tests were performed by means of a modified ultra-microhardness tester with a span of 380 microm and a bending direction <210> of the single crystals. The crystals were broken in air, water, and air after immersion in a cell culture medium for 3 wks. The average Young's modulus of the single crystals was from 54 to 79 GPa. The average bending strength of the single crystals in air was 500+/-184, 468+/-205, 513+/-151, and 450+/-162 MPa for those with 0, 0.09, 0.37, and 0.62 wt% carbonate, respectively. No significant decrease in strength was found for hydroxyapatite single crystals both in water and after the immersion in the medium. However, the strength of OH-carbonated hydroxyapatite single crystals decreased significantly by 23 to 43% in water in proportion to the carbonate content. The strength of single crystals with 0.37 and 0.62 wt% carbonate decreased significantly, even after the immersion in the medium. Therefore, hydroxyapatite single crystals are superior to OH-carbonated hydroxyapatite single crystals as a biomaterial for a load-bearing purpose.

Air↗

Bending strength of synthetic OH-carbonated hydroxyapatite single crystals.

Although hydroxyapatite (HAP) is applied to medical implants because of its biocompatibility, no data on mechanical strength of HAP single crystals were yet available, partly due to the difficulty in obtaining sufficiently large single crystals. In the present study the bending strength of OH-carbonated hydroxyapatite (CHAP) single crystals containing carbonate of 0.09 CO2 wt % prepared hydrothermally was determined in three-point bending tests. The three-point bending tests were performed using a modified ultra micro-hardness tester with a span of 380 micrograms and a bending direction of <210>. The CHAP single crystals were broken in air, water, and air after immersion in alpha minimum essential medium (alpha MEM) + 10% fetal bovine serum (FBS) for 3 weeks. The average bending strength of the CHAP single crystals was 468 +/- 205, 361 +/- 199 and 501 +/- 212 MPa in air, water, and air after immersion in alpha MEM + 10% FBS, respectively. In all cases the maximum strength at each crystal thickness value decreased in inverse proportion to the thickness.

Animals↗

KW-4679, an antiallergic drug, inhibits the production of inflammatory lipids in human polymorphonuclear leukocytes and guinea pig eosinophils.

The effects of (Z)-11-[(3-dimethylamino)propylidene]-6,11-dihydrodibenz [b.e.]oxepin-2-acetic acid monohydrochloride (KW-4679), an orally active antiallergic drug, on the production of platelet-activating factor (PAF), leukotriene (LT) and thromboxane (TX) induced by Ca2+ ionophore A23187 were examined. KW-4679 at 10 microM reduced the amount of cell-associated PAF by 52.8% in human polymorphonuclear leukocytes (PMNs). KW-4679 (1-100 microM) also inhibited the release of both LTB4 and TXB2, a stable metabolite of TXA2, by human PMNs in a concentration-dependent manner, but did not influence the release of beta-glucuronidase. The 50% inhibitory concentration (IC50) values for LTB4 and TXB2 release were 5.9 and 6.0 microM, respectively. In guinea pig eosinophils, KW-4679 inhibited the release of peptide LTs at a concentration higher than 10 microM (IC50 = 66.9 microM). KW-4679 failed to inhibit PAF acetyltransferase, 5-lipoxygenase and TX synthase, but inhibited the arachidonic acid release by human PMNs in a concentration-dependent manner in a similar concentration as that inhibiting production or release of lipid mediators (IC50 = 19.5 microM). These results indicate that KW-4679 suppresses LTs and TX release and PAF formation by reducing arachidonic acid release from phospholipids, probably through interference with phospholipase A2. The inhibitory action of KW-4679 on PAF, LT and TX production is a beneficial effect of an antiallergic drug.

Acetyltransferases↗

[New inactivating enzyme of aminoglycoside antibiotics produced by genes on R-plasmid of Serratia spp. and nosocomial infection].

Though incident due to Serratia spp. has decreased with the use of third generation cephems, S. marcescens with multiple drug resistance are still clinically occasionally isolated S. marcescens strains 218, 219 and 220 we isolated clinically, were found to possess aminoglycoside inactivating enzyme activities which had not been expected to exist in Serratia spp. These isolates inactivated aminoglycoside antibiotics except strains 218 and 219 were sensitive to isepamicin whereas strain 220 was sensitive to isepamicin and gentamicin. It was found that strains 218 and 219 possessed aminoglycoside inactivating enzyme AAC(2'), and strain 220 AAC (6'). The genes coding for these inactivating enzymes were found to be on R-plasmid and transferred between bacterial cells. Frequencies of transfer of the R-plasmid from Serratia to Escherichia coli chi-1037 were be low, but the transfer definitely occurred as frequencies of 4.3 x 10(-7) from strain 218, 5.2 x 10(-7) from strain 219, and 8.3 x 10(-7) from 220 were determined. To prevent nosocomial infections, the eradication of multi-resistant Serratia strains is strongly recommended when they are isolated even apparent symptoms of infections are not observed.

Aminoglycosides↗

[Clinical examination of ceftibuten in acute bronchitis].

Clinical evaluation of ceftibuten (CETB, 7432-S) was performed in 20 patients with acute bronchitis. They were consisted of 10 males and 10 females aged from 20 to 80 years old. CETB was given orally in daily dose of 300 mg (18 cases) or 600 mg (2 cases) in three divided portions. The duration of administration was 3 to 14 days. Especially they were given for 7 days in 16 cases. A total of 11 strains comprising 4 strains of Staphylococcus aureus, 2 strains of beta-Streptococcus and 1 strain each of Streptococcus pneumoniae, Branhamella catarrhalis, Klebsiella oxytoca, Serratia marcescens, Acinetobacter lwoffii were identified from sputa before administration. All of the above bacteria were eradicated but, in 1 case, a strain of Streptococcus pyogenes appeared after the treatment (eradication ratio = 100%). The clinical efficacy rate was 100%: Responses were excellent in 3 cases and good in 17 cases. There was no side effect and no abnormal changes in laboratory test results. From the avobe results, it is concluded that CETB is effective, safe and useful new oral cephem on acute bronchitis.

Acute Disease↗

Clinical study of drug fever induced by parenteral administration of antibiotics.

The incidence and clinical features of drug fever induced by antibiotics were investigated. Of a total of 390 patients analyzed, 193 had malignant diseases (lung cancer in most cases) and the remaining 197 had non-malignant diseases, of which the majority comprised pulmonary infectious diseases such as pneumonia, lung abscess and chronic infections. beta-Lactams most frequently induced drug fever. Piperacillin induced drug fever in 18 of 108 (17%), cefotaxime in 11 of 72 (15%), ceftizoxime in 7 of 49 (14%) and cefoperazone in 6 of 74 patients (8%). In contrast, the incidence of drug fever caused by ampicillin and that by cefazolin were in one of 39 (3%) and in none of 44 (0%), respectively. On the other hand, antimicrobial agents other than beta-lactams only rarely induced drug fever. The higher incidence of drug fever caused by newer derivatives of beta-lactam antibiotic suggests that the side chain attached to their core moiety might be involved in the mechanism of drug fever. In patients with malignancy who were on antibiotics, respiratory infection was the most frequent cause of fever exceeding 38 degrees C. In contrast, in patients with non-malignant diseases, the use of antibiotic per se was the most frequent cause of the fever which recurred during antibiotic therapy after a previous febrile episode had subsided. The most common feature of drug fever induced by the use of an antibiotic was as follows: A low-grade fever at the time of onset is followed by a high and remittent fever. The highest diurnal body temperature rises gradually, and then the fever subsides promptly after cessation of the causative antibiotic. The fever of this type accounted for 70% of all the drug fever in this study. A transient elevation of serum level of lactic dehydrogenase was associated with drug fever in one half (25/49, 51%) of the patients. A transient and slight decrease from the normal range in counts of neutrophils and platelets were observed in 11 (23%) and in 4 (8%) of 48 patients with drug fever, respectively. These changes in laboratory findings were considered as the possible consequence of allergic processes involved in the development of drug fever and thus seem to be a helpful index for establishing the diagnosis of drug fever.

Adult↗

A case of giant mediastinal leiomyoma with long-term survival.

A 67-year-old female was emergently admitted to our hospital because of severe dyspnea with cyanosis. One month before admission, she consulted a doctor and chest x-ray disclosed a huge tumor shadow occupying most of the left hemithorax. At that time, she did not complain of any particular symptoms except slight cough. Twelve days after admission, the patient lost consciousness and an emergency operation was performed. The tumor showed severe adhesion to the aorta and the lower lobe of the left lung, but not to the esophagus. After the operation, mechanical ventilation was necessary for 13 days to recover pulmonary function. Histological diagnosis was made as leiomyoma, which is rarely seen in the mediastinal region. At present, the patient survived 10 years without any symptom of recurrence. In this paper, the authors report a case of mediastinal leiomyoma which received an emergency operation and attained long term survival. Twelve similar cases reported in the past were also reviewed.

Aged↗