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Koichiro Kudo

Publications and source records attributed to Koichiro Kudo.

At least 37 records · Page 2Linked to original sources
PubMed2005

[Two cases of mature mediastinal teratoma complaining of sudden chest pain].

We report two cases of mature mediastinal teratoma complaining of sudden chest pain. Both cases had cystic lesions, multilocular and unilocular, and pleural effusion. One case had fat density by CT and MRI and calcification was not recognized in either case. Surgical resection of the tumor revealed pancreatic tissue in both cases, suggesting that pancreatic enzymes might have led to the rupture of the tumor. The diagnosis of teratoma and its rupture should be considered in the cases of cystic lesion in mediastinal with sudden onset of chest pain.

Adult↗
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↗
PubMed2004

Potential interactions between irinotecan and rifampin in a patient with small-cell lung cancer.

This report describes a patient with small-cell lung cancer who was infected with both Mycobacterium tuberculosis and non-tuberculous mycobacterium. He received irinotecan plus cisplatin, with and without rifampin. Rifampin slightly reduced the conversion of irinotecan to 7-ethyl-10-hydroxycamptothecin (SN-38), as determined by pharmacokinetic analysis. Rifampin may influence the metabolism and toxicity of irinotecan to some extent. However, there are possibilities to control M. tuberculosis and Mycobacterium avium complex infections in patients with small-cell lung cancer by using rifampin in combination with irinotecan plus cisplatin.

Antibiotics, Antitubercular↗
PubMed2004

Characterization of a trinucleotide repeat sequence (CGG)5 and potential use in restriction fragment length polymorphism typing of Mycobacterium tuberculosis.

The genomes of 28 bacterial strains, including mycobacterial species Mycobacterium tuberculosis and Mycobacterium bovis, were analyzed for the presence of a special class of microsatellite, that of trinucleotide repeat sequences (TRS). Results of a search of all 10 possible TRS motifs (i.e., CCT, CGG, CTG, GAA, GAT, GTA, GTC, GTG, GTT, and TAT) with five or more repeating units showed that (CGG)(5) was highly represented within the genomic DNA of M. tuberculosis and M. bovis. Most of the (CGG)(5) repeats in the genome were within the open reading frames of two large gene families encoding PE_PGRS and PPE proteins that have the motifs Pro-Glu (PE) and Pro-Pro-Glu (PPE). (CGG)(5)-probed Southern hybridization showed that some mycobacterial species, such as Mycobacterium marinum, Mycobacterium kansasii, and Mycobacterium szulgai, possess many copies of (CGG)(5) in their genomes. Analysis of clinical isolates obtained from Tokyo and Warsaw with both IS6110 and (CGG)(5) probes showed that there is an association between the fingerprinting patterns and the geographic origin of the isolates and that (CGG)(5) fingerprinting patterns were relatively more stable than IS6110 patterns. The (CGG)(5) repeat is a unique sequence for some mycobacterial species, and (CGG)(5) fingerprinting can be used as an epidemiologic method for these species as well as IS6110 fingerprinting can. If these two fingerprinting methods are used together, the precise analysis of M. tuberculosis isolates will be accomplished. (CGG)(5)-based fingerprinting is particularly useful for M. tuberculosis isolates with few or no insertion elements and for the identification of other mycobacterial species when informative probes are lacking.

Base Sequence↗
PubMed2003

Uptake rates of 18F-fluorodeoxyglucose and 11C-choline in lung cancer and pulmonary tuberculosis: a positron emission tomography study.

STUDY OBJECTIVE: The purpose of this study was to examine the uptake rates of (18)F-fluorodeoxyglucose (FDG) and (11)C-choline in patients with lung cancer, pulmonary tuberculosis, and atypical mycobacterial infection of the lung by positron emission tomography (PET) scanning with relation to their tumor size. DESIGN: Ninety-seven patients with untreated lung cancer, 14 patients with untreated pulmonary tuberculosis, and 5 patients with untreated atypical mycobacterial infection were examined. The diagnosis of lung cancer was confirmed pathologically after biopsy and surgery. The diagnosis of tuberculosis and atypical mycobacterial infection was confirmed by bacterial culture. The uptake rates of FDG and (11)C-choline were presented quantitatively as the standardized uptake value (SUV). SETTING: International Medical Center of Japan. RESULTS: In lung cancer patients, the SUV of FDG increased with increasing tumor size, whereas the SUV of (11)C-choline was almost constant at around 3.5 for every tumor size. In tuberculosis patients, the SUV of FDG increased with increasing tumor size, whereas the SUV of (11)C-choline was almost constant at around 2 for every tumor size. In atypical mycobacterial infection patients, the SUV of FDG and the SUV of (11)C-choline were equally low at around < or = 2. CONCLUSION: The differences in the SUVs of FDG and (11)C-choline in patients with lung cancer, tuberculosis, and atypical mycobacterial infection for the same tumor size (tumor size, > 1.5 cm) were distinct. In lung cancer patients, the SUVs of both FDG and (11)C-choline were high. In tuberculosis patients, the SUV of FDG was high, but the SUV of (11)C-choline was low. In atypical mycobacterial infection patients, the SUVs of both FDG and (11)C-choline were low. It may be possible to apply this principle to make a presumptive diagnosis of a solitary pulmonary nodule if it is too small to make a definitive diagnosis pathologically and bacteriologically.

Aged↗
PubMed2003

[Coagulation activity in the airways of asthmatic patients].

Fibrin deposition in the mucus plugs of asthmatic patients has long been known, and asthmatic sputum has been held to be important in the pathogenesis of bronchial obstruction. We examined the coagulation activity in the airways of asthmatic patients. Albumin as an index of plasma leakage into the bronchial lumen, thrombin antithrombin III complex (TAT), tissue factor, FDP, D-dimer and the TAT/D-dimer ratio as indices of coagulation and fibrinolytic markers were determined in expectorated or hypertonic saline-induced sputum from patients with acute and stable asthma, and with chronic bronchitis, and from normal control subjects. Patients with acute asthma, in comparison with patients with stable asthma or chronic bronchitis and normal control subjects, had significantly higher levels of albumin, TAT and TAT/D-dimer. The fibrin antigen was more positively stained immunohistochemically in sputum from acute asthmatics than in other sputa. In both patients with acute asthma and those with stable asthma, there was a significant positive correlation between albumin and TAT or albumin and TAT/D-dimer in the sputum. However, in normal control subjects, there was no correlation between these markers. These results suggest that the coagulation system in the airways of acute asthmatic patients is activated, that this favors fibrin deposition in the bronchial lumen and that coagulation pathways in the bronchial compartment and the degree of plasma exudation into the airways are dependently regulated in patients with asthma but not in normal control subjects.

Adult↗
PubMed2003

[A case of schwannoma of the chest wall showing a bead-like appearance in MRI].

A 31-year-old man was referred to our hospital because of a chest X-ray abnormality. Computed tomography showed an extra-pulmonary mass along the left 8th rib. T1-weighed magnetic resonance imaging (MRI) revealed a mass lesion with intermediate signal intensity. T2-weighed MRI showed a high signal intensity in peripheral and multiple central portions with intermediate signal intensity, which yielded a bead-like appearance. Gadopentetate dimeglumine-enhanced T1-weighted MRI showed marked contrast enhancement in the central zone of the mass. En bloc resection of the mass with the left 8th rib was performed. The tumor resembled a rosary in gross appearance, and histological examination confirmed the diagnosis of a benign schwannoma arising from the intercostal nerve. The bead-like appearance in the MRI was unique and had never been reported before for such a tumor. The postoperative course was uneventful, and the patient has been well for eighteen months.

Adult↗
PubMed2002

Activation markers of human basophils: CD69 expression is strongly and preferentially induced by IL-3.

BACKGROUND: The biological functions of basophils are precisely regulated by various cytokines in vitro, but little is known about surface markers that are upregulated during the cytokine-mediated activation process. OBJECTIVE: It has been well established that CD69, CD44, and CD54 represent "activation markers" for cytokine-mediated eosinophil activation. The objective of this study was to elucidate the expression and regulation of these molecules in human basophils in vitro as well as in vivo. METHODS: Basophils were purified from venous blood by means of density gradient centrifugation followed by negative selection. Surface expression was analyzed by means of flow cytometry. We also studied the expression of CD69, CD44, and CD54 on basophils in bronchoalveolar lavage fluid and blood specimens from patients with asthma. RESULTS: CD44 and CD54 were constitutively expressed on basophils and moderately upregulated by IL-3. On the other hand, CD69 expression was only weakly observed in freshly isolated basophils, but IL-3 induced extremely high levels of expression. Surface CD69 appeared rather slowly in comparison with CD63 and CD11b, and the induction of expression was completed within 24 hours. Basophil CD69 had no functional relevance, but it did have biological relevance. Whole blood basophils from asthmatic individuals expressed significantly higher levels of CD69 than did those from normal individuals. Furthermore, bronchoalveolar lavage fluid basophils showed higher levels of CD69 expression than did blood basophils from the same donors. CONCLUSION: CD69 expression on basophils was preferentially and strongly upregulated by IL-3. CD69 on basophils might be useful as an in vitro as well as in vivo marker of activation of these cells by IL-3.

Aged↗
PubMed2002

[A case of eosinophilic pneumonia induced by Pelex granule].

We report a case of eosinophilic pneumonia induced by Pelex granule. A 31-year-old male patient had been treated with Pelex granule and other drugs for common-cold symptoms such as cough and fever. Since these symptoms were persistent, he was admitted to our hospital for further examination. His laboratory findings showed eosinophilia and a mild elevation of serum IgE. Chest radiography revealed a reticular shadow and patchy shadows in both lung fields. Analysis of the bronchoalveolar lavage fluid (BALF) showed an increased percentage of eosinophils. The histological findings of the specimen obtained by transbronchial lung biopsy showed infiltration of eosniophils into the alveolar walls and spaces. After withdrawal of all drugs, the patient's clinical findings-symptoms, laboratory data, and chest radiographic findings-soon improved. A lymphocyte stimulation test (LST) for Pelex granule was positive. Taken together, the case was diagnosed as eosinophilic pneumonia induced by Pelex granule.

Acetaminophen↗
PubMed2002

[A case of multiple bone and joint tuberculosis which had been misdiagnosed as the rheumatoid arthritis and treated with prednisolone for eleven months].

A 34-year-old man had a multiple arthralgia for about eleven months. The swelling of his right wrist and foot had appeared in the dorsal side, and he had been misdiagnosed as the rheumatoid arthritis. He was treated with prednisolone in the dosages of 2.5 mg per day for one month, and 10 mg per day for ten months. When he admitted to our hospital, the bone X-ray examinations of the wrist and foot revealed the marked atrophy and destruction of the carpal and tarsal bones. The aspiration fluid from the swelling around his wrist and foot was positive for acid-fast bacilli on smear and Mycobacterium tuberculosis was found on culture. He was treated with isoniazid, rifampicin, ethambutol and pyrazinamide, however, these medication was not adequately effective to his complications of tuberculous arthritis. Curettage, irrigation and synovectomy of his right carpal and tarsal bone were performed in order to control his bone and joint infection. He recovered from his arthritis and tenosynovitis after these operations. The clinical practitioners should not omit tuberculosis from the differential diagnosis of persistent osteoarthralgia.

Adult↗
PubMed2002

[A case of lymphomatoid granulomatosis with multiple thin-walled cavities].

We report a case of rapidly progressive lymphomatoid granulomatosis. A 48-year-old man was admitted because of hemoptysis and high fever. A chest radiograph and chest computed tomograms revealed multiple nodules, thin-walled cavities in the lungs, some containing ball-like masses. After admission, clinical studies, including percutaneous and transbronchial biopsies failed to provide sufficient evidence for proper diagnosis. Fluoro-deoxyglucose positron emission tomography (FDG-PET) showed strong accumulations of abnormal shadows in the lesions. A VATS biopsy was performed to make possible an exact diagnosis. The histological findings showed angiocentric lesions with infiltration of polymorphous cells, and were compatible with lymphomatoid granulomatosis (LYG). The respiratory failure progressed as the reticular shadows in the chest radiograph increased, so treatment with methylprednisolone pulse therapy (1,000 mg/day for 3 days) was started, and followed with prednisolone therapy (60 mg/day for 3 weeks). Initially, the symptoms improved, but gradually deteriorated, and the pulmonary nodules became enlarged. The patient finally died of progressive respiratory failure in addition to uncontrollable empyema with an MRSA infection. We attributed the cavity formation and ball-like masses in the cavities to the occlusion of small pulmonary arteries and tissue necrosis along the drainage bronchus.

Fluorodeoxyglucose F18↗