Biomedical subjects
Publications and source records attributed to M Adachi.
Viral infection induces airway inflammation. It is possible that bronchial epithelium derived chemokine contributes to the migration and accumulation of inflammatory cells in the airway viral infection. We infected bronchial epithelial cells with influenza virus and analysed mRNA expression and production of RANTES. The expression of mRNA and the production of RANTES were detected in infected cells using RT-PCR method and ELISA.
A questionnaire on the evaluation of "The Guidelines on Diagnosis and Management of Asthma" edited by the Japanese Society of Allergology in 1993 was sent to 586 physicians consisting of specialists authorized by the Japanese Society of Allergology and the board members of this Society, who treated patients with bronchial asthma. Of total 306 (52.2%) who responded, 177 (57.8%) answered the questions on adult asthma only, 65 (21.2%) on childhood asthma only and 52 (17.9%) on both adult and childhood asthma. In total, we had 229 respondents on adult asthma and 117 on childhood asthma. As a result, on drug therapy for chronic asthma, it was pointed out that the use of oral anti-allergics, oral steroids and inhaled beta-stimulants was excessive whereas the use of DSCG, inhaled steroids and long acting theophylline was slightly insufficient in both adults and children. On the management of acute episodes, the excessive use of beta-stimulants (inhaled, oral and injections) and the lack of the use of parenteral steroids and oxygen inhalation were pointed out in adults. The lack of oxygen inhalation also got a higher percent in children. Nevertheless, the guidelines were found to be highly regarded as a whole: "Very good" was 6.1% in adults (6.8% in children). "Appropriate" 38.0% (33.3%), "Almost appropriate" 52.0% (52.1%) and "Inappropriate" 3.9% (3.4%).
We surveyed 850 patients with bronchial asthma and investigated such clinical features as the frequency of aspirin-induced asthma and hypersensitivity to steroids in the 457 available answers. We divided them into two groups, one was ASN: the asthmatics who had history of hypersensitivity to non-steroidal anti-inflammatory drugs, another was non-ASN: the asthmatics who had no history of hypersensitivity to non-steroidal anti-inflammatory drugs, and compared the two groups. The survey showed that the frequency of ASN was 12.0%. Its frequency rose with the severity of asthma to a level of 29.0% in severe cases. In ASN it was more frequent rates of female, infectious type, severe cases, and ASN had more frequent histories of oral use of steroids, use of ambulance, treatment in emergency rooms, and hospitalization than non-ASN. The serum IgE level was lower in ASN. The patients were 6 in ASN, none in non-ASN who had histories of hypersensitivity to steroids. They were 1.3% in all patients. 5 of 6 had past asthma attack progressived severely by rapid injection of succinate ester steroids and 2 of 6 had past by rapid injection of phosphoric acid ester steroids. In conclusion it was considered that we had to avoid rapid injection of steroids to aspirin-induced asthma and severe cases who were doubtful of aspirin-induced asthma in case of treatment of asthma attack.
We investigated the effect of IPD-1151T (Suplatast Tosilate, (+/-)-[2-[4-(3-ethoxy-2-hydroxypropoxy) phenyl-carbamoyl]-ethyl] dimethylsulfonium p-toluenesulfonate) against allergic bronchoconstriction induced by allergen and methacholine (MCh).BALB/c mice were sensitized by intraperitoneal injection of 0.5 microgram of keyhold limpet hemocyanin mixed with Al(OH)3. IPD-1151T was administered orally once a day for 5 or 14 days in doses of 10, 30 or 100 mg/kg body weight. Bronchoconstriction was measured 24 hrs after the final drug administration. IPD-1151T inhibited both antigen-mediated allergic bronchoconstriction and induction of bronchial hyperresponsiveness after sensitization or allergen challenge in actively sensitized mice. The degree of inhibition was proportional to the dose and frequency of oral administration of the agent.
A gene of unknown biological function, nbl, was originally isolated by virtue of its abundance in a Namalwa Burkitt Lymphoma cDNA library. nbl expression was initially found to be higher in tissues which exhibited internucleosomal DNA cleavage characteristic of apoptosis, than in tissues which did not exhibit a 'DNA ladder'. nbl expression was therefore examined in mouse thymus in vivo, in which apoptosis is induced by the glucocorticoid, dexamethasone. nbl expression was markedly enhanced by dexamethasone treatment and then sharply decreased prior to the occurrence of maximal 'DNA ladder' formation. In contrast, expression of myc, which is believed to be involved in apoptosis in other cell systems, declined as thymic apoptosis increased. Thymic apoptosis was blocked by the transcriptional inhibitor actinomycin D, if administered when nbl expression was enhanced, but not before or after the peak of nbl expression. These results suggest that nbl expression is associated with thymic apoptosis.
In 31 adult patients who had undergone spinal or epidural anesthesia, we evaluated the effect of flumazenil in reversing midazolam, flunitrazepam or diazepam. The patients received midazolam 5 mg, flunitrazepam 1 mg or diazepam 5 mg 15 min after the spinal or epidural anesthesia. After the completion of operation, flumazenil (0.2 mg-1.0 mg) was administered until the patient became awake. Blood pressure, pulse rate and respiratory rate before and after administration of flumazenil showed no statistically significant changes in these groups. There were no significant differences in necessary amount of flumazenil among these groups. The time necessary for the patient to be awake in midazolam group was significantly shorter than that in flunitrazepam or diazepam group. Half of the patients in flunitrazepam and diazepam groups slept again after leaving the operating room, but they presented no clinical problems. In conclusion, we consider that flumazenil does not affect circulation and respiration, so it seems to be safe and effective for reversing benzodiazepins in clinical situation.
Using an 1.5 Tesla superconducting MR unit and surface coil, 12 mandibular fracture patients were evaluated for TMJ disk change. Sagittal and coronal images of the TMJ with a slice thickness of 2mm were obtained with FISP 2D or 3D. TR = 30 msec, TE = 12 msec, and flip angle = 40 degrees were applied. Among 12 patients, FISP 3D revealed increased signal intensity of the disk in 70% of cases. Traumatic fluid collection at or adjacent to the TMJ showed high intensity. The disk was displaced anteromedially regardless of the site of fracture.
The effects of roxithromycin (RXM), an antibiotic of the macrolide family, on respiratory bacterial infection in mice were examined. BALB/c mice were administered with RXM orally at a dose of 5.0 or 2.5 mg/kg once per day for 14 days. On day 2 after the final drug administration, the mice were nasally infected with Haemophilus influenzae. RXM dose dependently inhibited the pathological changes in lung tissues induced by H. influenzae infection. RXM also enhanced 2',5'-oligoadenilate synthetase production in response to infection.
Bronchial asthma is characterized as a chronic inflammation of the airway that causes an infiltration of lymphocytes and eosinophils. Cell to cell interaction or cell to tissue interaction is essential for infiltration of eosinophils to underlying tissues. These phenomena are closely related to the expression of intercellular adhesion molecule-1 (ICAM-1). Inhalation of steroids, such as beclomethasone dipropionate, is commonly used to cure airway inflammation. In this study, we investigated the effect of cytokines on ICAM-1 expression on human bronchial epithelial cell lines, NCI-H292. Moreover, the effect of dexamethasone on ICAM-1 expression stimulated by IL-1 beta, TNF-alpha and IFN-gamma was observed. Treatment with IL-1 beta, TNF-alpha and IFN-gamma dose-dependently increased ICAM-1 expression on NCI-H292 cells. Inhibitory effects were exerted by dexamethasone on ICAM-1 expression in cells stimulated by IL-1 beta and IFN-gamma in a dose-dependent manner, but not in cells stimulated by TNF-alpha. These results suggest that the inhibition of ICAM-1 expression could be related to the pharmacological action of steroid drugs.
Portable 24-hour polygraphic monitorings were performed on 109 cases with neurological or cardiovascular disorders, sleep disturbances and metabolic diseases to clarify its usefulness and limitations. Moreover, an evaluation of autonomic nervous activity was done in different stages of sleep in normal young (n = 9), normal middle-aged subjects (n = 8) and patients with ischemic heart disease (n = 7) using power spectral analysis of heart rate. The parameters recorded in this study were electroencepharogram(EEG), electrooculogram, electromyogram of chin muscles, electrocardiogram, respiratory curve, walking pulse and body position. Using polygraphic monitoring, the patients with cardiac arrhythmia showed abnormal EEG in 20% and those with neurological events in 86.7%. The improvement of sleep structure was found after pacemaker implantation in the patients with bradyarrhythmias (75%). Time spans of slow wave sleep and REM sleep of patients with ischemic heart disease decreased significantly from 120.9 +/- 40.6 min to 79.1 +/- 25.3 min, 112.8 +/- 16.5 min to 63.6 +/- 23.6 min, respectively (p < 0.05). RR50, that is number of R -R intervals greater than 50msec compared to the preceding R-R interval, decreased significantly in each stage of sleep in the patients with ischemic heart disease compared to normal subjects (stage 2: 18.3 +/- 6.1/min to 3.8 +/- 3.0/min, p < 0.01; SWS: 7.8 +/- 8.0/min to 3.2 +/- 2.5/min, p < 0.05; REM: 17.9 +/- 6.0/min to 4.4 +/- 4.3/min, p < 0.01). The HF power in all stages of sleep showed a trend of the decrease in the patients with ischemic heart disease. In REM sleep, the LF power in patients with ischemic disease was lower significantly compared to that in normal middle-aged subjects (6.1 +/- 3.2 to 12.1 +/- 4.1, p < 0.05). The L/H ratio also decreased significantly (1.08 +/- 0.30 vs. 2.35 +/- 1.03, p < 0.05). The slope of 1/fx above 0.15Hz in IHD patients was less in stage 2 (-0.404 +/- 0.280 vs. -0.849 +/- 0.183, p < 0.01) and in REM sleep (-0.294 +/- 0.368 vs. -0.665 +/- 0.291, p < 0.05). Above results suggest the involvement of a decrease of sympathetic activity in addition to decrease of parasympathetic activity especially in REM sleep in the patients with ischemic heart disease. In conclusion, polygraphic monitoring is useful for a detection of abnormality of EEG and an evaluation of autonomic activity in cardiovascular disorders.
Cuff-occluded rate of rise of peripheral venous pressure (CORRP) was evaluated for perioperative monitoring. We investigated the CORRP in 6 patients undergoing open laparotomy. These patients were given general anesthesia, and monitoring lines were inserted. Heart rate, blood pressure (BP), right atrial pressure (RAP), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressure (PAP), cardiac output (CO) and CORRP were monitored. CORRP is defined as the average rate (in millimeters of mercury per minute) of rise of peripheral venous pressure after proximal occlusion of that vein by a tourniquet (select pressure: 50 mmHg). In the actual measurement of CORRP, only the first 90% of the curve after occlusion of the tourniquet is used. CORRP correlated with RAP (r = 0.69 +/- 0.10), and PCWP (r = 0.79 +/- 0.07). On the other hand, there was no significant correlation between CORRP and BP, or PAP and CO. Snyder et al. described that CORRP seems to be an excellent indicator of acute volume change in the hyper- and hypovolemic canine model. We conclude that in these laparotomy patients, CORRP appears to be a sensitive and minimally invasive method of assessing volume status.
The effects of cyclopiazonic acid (CPA), which is reported to inhibit Ca++ uptake into intracellular Ca++ store sites in skeletal and smooth muscles, were examined in ventricular myocardia of the adult rat. In isolated papillary muscle, 0.3 to 30 microM CPA concentration-dependently decreased the contractile force and prolonged the relaxation phase of twitch contractions. In skinned papillary muscle with functional sarcoplasmic reticulum (SR) preserved, application of CPA during the Ca++ loading period reduced the peak tension of subsequent caffeine-induced contractions. When CPA was applied during exposure to caffeine, it had no significant effect on the peak tension, but prolonged the decay of the caffeine-induced contraction. CPA had no substantial influence on the pCa-tension relationship of skinned fibers without functional SR. CPA had no substantial influence on the peak inward and steady-state membrane currents of isolated myocardial cells. These results suggest that CPA inhibits Ca uptake into SR by acting as a specific inhibitor of SR Ca(++)-ATPase in cardiac muscle as in skeletal and smooth muscles and thus provides a valuable pharmacological tool for studying myocardial excitation-contraction mechanisms.
Body surface mapping is constructed from numerous electrocardiographic data, obtained from many lead points distributed over the entire thorax. It is generally accepted that the electrocardiographic features of ventricular hypertrophy consists of increase of voltage and prolongation of conduction time. In this report, the usefulness of body surface mapping in diagnosing the quantitative evaluation of left ventricular hypertrophy is reviewed. Finally, we attempted to diagnosis the severity of repolarization abnormalities from QRST isointegral map of patients with left ventricular hypertrophy.
It was during the past few years that postprandial hyperlipidemia is believed to be more closely related to a risk for coronary artery disease. However, the high variability in the postprandial triglyceride (TG) levels could have made overlooked such diagnostic value in estimating an individual's risk for coronary artery disease. To minimize the impact of such variability, the remnant lipoproteins, TG-rich lipoproteins, might be measured in cholesterol using remnant-like particles (RLP-C) assay as a more reliable marker. In place of the previous cholesterol reagent (CHOD-Iodine) in RLP-C assay, the RLP-C assay was improved by employing a new cholesterol reagent (POD-EMSE). The correlation between these two assays was high (r = 0.978). The variations in RLP-C levels in healthy normolipidemic subjects was within 7.5mg/dl in a day. In oral-fat loading test, the variations of RLP-C levels in healthy subjects were also within 7.5mg/dl. However, patients with coronary artery disease showed much higher levels (over 7.5mg/dl) of RLP-C during the test. In conclusion the RLP-C assay can be used for the measurement of remnant lipoproteins in serum prepared from the fasting as well as postprandial states for predicting subjects who may be at risk of coronary artery disease.
We encountered three patients with spontaneous pneumomediastinum. All three (two men and one woman) were previously healthy. They complained of chest pain or dyspnea. On admission, physical examination revealed subcutaneous emphysema. Chest roentgenograms and computed tomograms revealed pneumomediastinum and subcutaneous emphysema. All other findings were normal. All patients were treated with bed rest and all recovered in 7 to 9 days. Pneumomediastinum recurred in one patient after 20 months.
The clinical study and in vitro study used with leukocytes were made of a case of food-dependent exercise-induced anaphylaxis induced by shrimp. A 26-year-old man experienced anaphylactic reaction of nasal obstruction, face edema and dyspnea while running 90 minutes after eating shrimp. He experienced similar episodes two years ago in his past history. IgE-RAST was positive for shrimp. Anaphylactic reaction and elevation of plasma histamine levels were verified by exercise challenge test after eating 100 g shrimp. At the same time, we verified the dedine of plasma cAMP levels after eating shrimp. In leukocyte stimulating test used with shrimp antigen, histamine level elevations, which were lower compared with calcium ionophore A23187 (Ca I 10(-6) M) stimulation, were recognized in dose dependent manner in this patient. But in normal subject, histamine level elevations were not recognized. We diagnosed him food-dependent exercise-induced anaphylaxis. It was suggested that there was relation between histamine release and decline of cAMP levels of plasma after eating shrimp in this case.
We measured serum IgE antibodies by the MAST and the CAP RAST in 90 patients refered to our asthma clinic and compared their results. Furthermore the patients with CAP positive/MAST negative were investigated by bronchial provocation test with allergen, skin test and CAP RAST inhibition test. Significant correlations were obtained between the results of the MAST and those of the CAP RAST for house dust 2 (r = 0.617), for Dermatophagoides farinae (r = 0.776) and for Japanese cedar (r = 0.609), but not for all 3 mold allergens. CAP positive/MAST negative results were found in 1.4-27.8% and MAST positive/CAP negative results were found in 0-2.7%. The presences of specific IgE antibodies were confirmed by a positive bronchial provocation test with allergen, skin test and CAP RAST inhibition test in CAP positive/MAST negative results. Those results indicate that the CAP RAST is more sensitive than the MAST.
In recent years, high resolution X-ray CT has provided detailed information on calcification of the basal ganglia. At this institution, a review of 30 patients with 57 globus pallidus calcifications revealed curvilinear non-calcified lines in 19 calcifications. These were considered to be the medial medullary lamina of the globus pallidus. An attempt was made to classify calcifications of the globus pallidus into calcifications of the medial and lateral segments by the non-calcified line or location of the calcification, and to assess the tendency to calcify of both the medial and lateral segments. The results of this assessment revealed that the lateral segment tended to calcify more than the medial segment.