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Biomedical subjects

M Iwata

Publications and source records attributed to M Iwata.

At least 397 records · Page 22Linked to original sources
PubMed1991

Myxoid variant of epithelioid leiomyosarcoma of the uterus.

A rare case of myxoid variant of epithelioid leiomyosarcoma of the uterus in a 76-year-old woman is reported. Palpation and computed tomography revealed an enlarged uterus. Total hysterectomy and bilateral salpingo-oophorectomy were performed, and a hemispheric tumor, measuring 2.7 x 2.5 x 1.8 cm, was found protruding into the uterine cavity of the upper uterine segment. The tumor contained a prominent myxoid stroma and epithelioid tumor cells, which were round and polygonal in shape and showed positive immunoreactivity for desmin and vimentin. High mitotic activity was observed in the tumor cells. Electron microscopic examination revealed bundles of filaments in the cytoplasm and fine reticular material in the extracellular matrix. Histochemically, the myxoid stroma contained abundant acid mucopolysaccharide. The tumor cells were considered to originate from smooth muscle cells, while the myxoid stroma expressed varying differentiation of uterine mesenchymal cells. The patient is currently well with no evidence of recurrence or metastasis one year after the operation.

Aged↗
PubMed1991

Morphological and immunohistochemical studies of the lungs and bronchus-associated lymphoid tissue in a rat model of chronic pulmonary infection with Pseudomonas aeruginosa.

Pseudomonas aeruginosa is one of the most frequently encountered bacterial pathogens in patients with chronic pulmonary infections, including cystic fibrosis and diffuse panbronchiolitis. Bronchus-associated lymphoid tissue (BALT), noted frequently in patients with cystic fibrosis and diffuse panbronchiolitis, is considered to play an important role in the local immunologic defense mechanisms in the respiratory tract. To investigate the role of BALT in chronic pulmonary infections, we developed an animal model for chronic pulmonary infection and studied the morphological and immunohistochemical characteristics of BALT. Experimental pneumonia was produced in rats by intratracheal inoculation of P. aeruginosa enmeshed in agar beads. The histological changes corresponded to those occurring in chronic bronchiolitis. Immunohistochemically, surface immunoglobulin M-positive (sIgM+) cells and sIgA+ cells were recognized in the inflamed bronchial walls from day 4, and sIgG+ cells were recognized from day 14, W3/25+ cells exceeded OX8+ cells in number until day 14. In the BALT, there was a massive accumulation of lymphocytes in the lymphatics and high endothelial venules. The development of germinal centers was accompanied by increased numbers of sIgM+ and sIgA+ cells. W3/25+ cells exceeded OX8+ cells in number in the BALT until day 14. On the other hand, OX8+ cells were predominant in comparison with W3/25+ cells at day 21, and then both sIgM+ and sIgA+ cells and inflammatory changes in the lung decreased at day 28. These findings suggest that BALT regulates the local immune responses against chronic pulmonary infection due to P. aeruginosa.

Animals↗
PubMed1991

Mid-brain pathology of Wilson's disease: MRI analysis of three cases.

MRI scans were obtained from three patients with Wilson's disease, all of whom showed rigidity and dysarthria; two also showed tremor and dystonia. Two had been treated with D-penicillamine for seven and 14 years, respectively and their neurological abnormalities had improved, but the third patient had not been treated. T2-weighted MRI of the mid-brain in all three revealed the characteristic "face of the giant panda" sign, consisting of high signal intensity in the tegmentum except for red nucleus, preservation of signal intensity of the lateral portion of the pars reticulata of the substantia nigra and hypo-intensity of the superior colliculus. The clinical significance of these MRI abnormalities is discussed.

Adolescent↗
PubMed1991

A nationwide collaborative study on the long-term effects of bromocriptine in patients with Parkinson's disease. The fourth interim report.

The interim results of the nationwide collaborative study on the long-term effects of bromocriptine in patients with Parkinson's disease are reported. Four years ago, two prospective clinical studies were started to evaluate the long-term effects of bromocriptine in Parkinson's disease. The first was to investigate the long-term effects of bromocriptine monotherapy and the second to see the long-term effects of a combination therapy of bromocriptine with levodopa. Patients who had never been treated with levodopa were placed on bromocriptine monotherapy, and those who had been treated with levodopa for not more than 5 years were allocated randomly to either the combination or the levodopa group. Two hundred and eighty-six patients were enrolled in the former study and 416 in the latter. Among the 286 patients, 164 continued for further observation at the end of the fourth year, and 74 of them were still being treated with bromocriptine monotherapy. However, in 78, levodopa had to be added. Among the 416 patients in the second study, 216 were allocated to the combination group and 200 to the levodopa control group. At the end of the fourth year, 130 in the former and 140 in the latter group remained for further observation. In all three groups, a gradual loss of efficacy was noted. The rate of efficacy loss appeared largest in the monotherapy group and smallest in the combination group. Effects on tremor and rigidity are still maintained, but effects on akinesia and gait were lost by the end of the fourth year in all groups. Wearing-off and dyskinesias seem to be better managed by the combination therapy. The incidence of wearing-off was very small in the monotherapy group. No serious side effects were encountered except for 1 patient who died of pulmonary fibrosis in the combination group.

Bromocriptine↗
PubMed1991

Long-term effects of ofloxacin on clinical courses in patients with diffuse panbronchiolitis.

To ascertain the long-term effects of ofloxacin (OFX) on clinical parameters in cases of diffuse panbronchiolitis (DPB), we treated 18 patients with this disease with OFX and compared the clinical findings before and after treatment. Pulmonary function tests including percent vital capacity, arterial oxygen tension and arterial-alveolar oxygen tension difference significantly improved with OFX. In addition, the incidence of acute exacerbation and the duration of hospitalization were reduced. These observations indicate that OFX is a useful drug for the management of chronic respiratory infections such as DPB.

Bronchiolitis↗
PubMed1991

A multi-center, double-blind study on slow-release bromocriptine in the treatment of Parkinson's disease.

We report on the clinical efficacy of a slow-release formulation of bromocriptine studied in a multi-center, double-blind trial using standard bromocriptine as the control. We randomly allocated enrolled patients (N = 243) to either the slow-release or normal bromocriptine group. Sixty of them were de novo patients. The maintenance dose of slow-release bromocriptine was 14.2 +/- 0.7 mg/d and that of standard bromocriptine 13.5 +/- 0.7 mg/d (mean +/- SE). The slow-release formulation was taken twice and the standard three times a day. Forty-one percent of the patients treated with the slow-release bromocriptine and 32% of the patients treated with the standard bromocriptine showed moderate or marked improvement in the global improvement rating. There were no serious side effects, and the frequency of vomiting and epigastric discomfort was lower in the patients treated with the slow-release bromocriptine. Clinical efficacies for tremor, rigidity, akinesia, and gait disturbance were comparable between the two drugs tested. The slow-release bromocriptine seems to be a valuable drug for the treatment of Parkinson's disease with less severe side effects than regular bromocriptine.

Aged↗
PubMed1991

Human immunoglobulin preparation for intravenous use induces elevation of cellular cyclic adenosine 3':5'-monophosphate levels, resulting in suppression of tumour necrosis factor alpha and interleukin-1 production.

We previously showed that human immunoglobulin preparation for intravenous use (IGIV) suppresses the in vitro production of tumour necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) by rabbit peritoneal exudate cells (PEC) stimulated with lipopolysaccharide (LPS). In this study we investigated the mechanism of the suppression. IGIV treated at pH4 (pH4-G) was used as IGIV. Fc fragments of pH4-G, as well as untreated pH4-G, suppressed TNF-alpha and IL-1 production by rabbit PEC stimulated with LPS. The interaction of pH4-G with PEC also resulted in generation of cyclic adenosine 3':5'-monophosphate (cAMP), known to be an intracellular second messenger. N6, 2'-0-dibutyryl cAMP (BtcAMP), a lipid-soluble derivative of cAMP, and cholera toxin (CT), an adenylate cyclase activating agent, also suppressed the production of TNF-alpha and IL-1. Further N-[2-(methylamino) ethyl]-5-isoquinolinesulphonamide dihydrochloride (H-8), an inhibitor of cAMP-dependent protein kinases, abrogated the suppression by pH4-G of the productions. These results indicate that the binding of IGIV to PEC via Fc gamma receptors (Fc gamma R) induces the elevation of intracellular cAMP levels, resulting in the suppression of LPS-induced TNF-alpha and IL-1 productions.

Animals↗
PubMed1991

[The significance of the heparin precipitable fraction in lung diseases].

The authors recently experienced a case of idiopathic interstitial pneumonia (IIP) that exhibited skin ulcers due to increased heparin precipitable fraction (HPF) in plasma. This case prompted us to investigate the occurrence and significance of HPF in interstitial pneumonia (IP). The subjects included patients with IIP (acute exacerbation 6 cases, chronic active stage 12 cases), IP associated with collagen vascular disease (CVD) (9 cases) and granulomatous lung diseases (7 cases). The data indicated that all of the cases with acute exacerbation of IIP exhibited increased plasma HPF values (218-951 mg/dl) compared to those of normal controls (less than 180 mg/dl). In contrast, the values ranged within normal limits in all of the cases with IP associated with CVD. In a companion study, we measured plasma HPF values in patients with lung cancer, bacterial pneumonia and diffuse panbronchiolitis. It was found that 22% of the subjects showed increased plasma HPF values. We also investigated whether there were correlations between plasma HPF and various inflammatory parameters. The data revealed that there were correlations between HPF and ESR, CRP, alpha 1-globulin, alpha 2-globulin, complement (C3) or fibrinogen. However, there was no correlation between HPF and fibronection. These results suggest that plasma HPF is valuable to evaluate the acute exacerbation of IIP, although the elevation of plasma HPF levels is not specific.

Acute-Phase Reaction↗
PubMed1991

[Fulminant mycoplasma pneumoniae infection presenting with Stevens-Johnson syndrome & respiratory failure].

An 18-year-old man was admitted to Hamamatsu University Hospital on February 15, 1985, with high fever, vesicular and papular rash involving the skin and mouth, conjunctivitis, productive cough and dyspnea. A diagnosis of Stevens-Johnson syndrome was made by skin biopsy, and chest X-ray showed an infiltrate in the right lower lung filed. Despite treatment with corticosteroids and antibiotics, the mucocutaneous lesions did not heal, and the pneumonia progressed to both lung fields. Because the patient had developed dyspnea, a tracheotomy was performed, mechanical ventilatory support was instituted, and high-dose corticosteroid therapy was started. However, jaundice due to intrahepatic cholestasis, hematuria, hematochezia, sepsis, and subcutaneous and mediastinal emphysema ensued, and the patient died of respiratory failure on March 1. Postmortem examination of the lung demonstrated diffuse alveolar damage. The complement-fixation titer for Mycoplasma was 1:64, compared with a level of less than 1:4 on admission. This case was though to be one of fulminant Mycoplasma pneumoniae infection presenting with Stevens-Johnson syndrome, respiratory failure and other extra-pulmonary complications.

Adolescent↗
PubMed1991

[Clinicopathologic study of various lung diseases with bronchiolitis obliterans organizing pneumonia (BOOP) pattern in open lung biopsy].

The histologic findings of BOOP are nonspecific, and the diagnosis of idiopathic BOOP is one of exclusion. We studied the clinicopathologic features of various lung diseases with histopathological appearance of bronchiolitis obliterans organizing pneumonia (BOOP) pattern in open lung biopsy specimens. The 17 patients with BOOP pattern studied included idiopathic BOOP (n = 7), unclassified interstitial pneumonia (n = 1), collagen vascular disease (n = 3, RA 1, PM/DM 2), hypersensitivity pneumonitis (HP, n = 2), eosinophilic pneumonia (EP, n = 1), multiple lung abscesses (n = 1), limited form of Wegener's granulomatosis (n = 1), and pneumocystis carinii pneumonia associated with adult T cell leukemia (n = 1). There were no differences in clinical symptoms, laboratory data, respiratory function, and cytological findings in bronchoalveolar lavage fluid (BALF) between cases of idiopathic BOOP and other lung diseases. The duration of clinical symptoms was less than one year in 16 patients (one case had no symptoms). Chest X-rays showed bilateral patchy, nodular, or reticular shadows in all cases. Multiple patchy migratory shadows were only observed in cases of idiopathic BOOP or EP. Organizing pneumonia was recognized in the transbronchial lung biopsy specimens of all patients with idiopathic BOOP, HP or EP. Regarding prognosis, relapses occurred in idiopathic BOOP (n = 5), polymyositis, EP, limited form of Wegener's granulomatosis, and Pneumocystis carinii pneumonia. Four patients with idiopathic BOOP relapsed when steroid therapy was decreased or stopped. These findings indicate that idiopathic BOOP should be differentiated from other lung diseases, and these patients should be followed for a long period of time.

Adult↗
PubMed1991

[Pulmonary interstitial pneumonia in association with Hermansky-Pudlak syndrome].

A 33-year-old albinotic woman whose parents were consanguineous was referred to our hospital with dry cough, dyspnea on exertion, and diffuse reticulonodular shadows on chest X-ray film. She had no apparent bleeding diathesis, although platelet serotonin content and ATP release were reduced. Open lung biopsy revealed pulmonary interstitial fibrosis with deposition of ceroid-like material with alveolar and interstitial macrophages. From these findings, the diagnosis of Hermansky-Pudlak syndrome (HPS) with interstitial pneumonia was mode. The reported characteristics of pulmonary interstitial pneumonia associated with HPS are occurrence of this disease in the thirties to forties, diffuse reticulonodular shadows in all lung fields with sparing of the subpleural zones, and bullous formation in the upper lobes. Progression usually occurs to diffuse interstitial fibrosis, but these is little decrease in lung volume. The prognosis of HPS with interstitial pneumonia is worse than that of uncomplicated HPS, and patients die of respiratory failure within 1 to 6 years after diagnosis. Steroid therapy is not effective.

Adult↗
PubMed1991

[A case of Klinefelter syndrome associated with lung cancer and RA lung].

A 50-year-old man was admitted for evaluation of an abnormal shadow on a chest X-ray. He had experienced pain and swelling in his fingers for three years. He had also noticed that he is impotent. The diagnosis of Klinefelter syndrome and rheumatoid arthritis (RA) was established by clinical findings and chromosomal analysis. Transbronchial biopsy revealed adenocarcinoma and right upper lobectomy was performed. Open lung biopsy showed interstitial pneumonia. In conclusion, we reported a rare case of lung cancer, rheumatoid arthritis and RA lung associated with Klinefelter syndrome.

Adenocarcinoma↗
PubMed1991

[Two cases of hypersensitivity pneumonitis due to contamination of an ultrasonic humidifier].

Two cases of hypersensitivity pneumonitis due to contamination of ultrasonic-humidifier were reported. The first case, a 64-year-old man, developed fever and dyspnea on exertion in January 1986. He was hospitalized for 18 days and received antibiotics for presumptive bacterial pneumonia. Half a day after discharge, those symptoms recurred. On readmission, fine crackles were heard at the left lung base, and chest X-ray film showed ground glass shadows all over the lung fields. Bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) were performed on the next day after readmission. TBLB specimen revealed lymphocyte alveolitis, granulomatous tissue and infiltration of polymorphonuclear neutrophils (PMN) in alveoli. Differential cell count of the BAL fluid showed not only lymphocytosis (38.2%) but also increased PMNs (44.2%). In the second BAL performed 18 days later, the value of PMNs demonstrated a dramatic decrease. Environmental challenge tests revealed that his hypersensitivity pneumonitis was caused by an ultrasonic humidifier in his bed room. Immunological examinations showed positive Arthus type skin reaction and serum precipitin against Aspergillus fumigatus. Inhalation challenge with A. fumigatus produced cough and dyspnea with a decrease of 10 Torr in PaO2. These data suggest that A. fumigatus may be the causative antigen in this case. The second case, a 64-year-old man who had used ultrasonic humidifier in his living room, was admitted for 8 weeks with an illness characterized by cough, low fever and general malaise on 22 January 1987. Examination revealed fine crackles on both lung bases. Chest X-ray film demonstrated diffuse nodular shadows. The TBLB specimen showed lymphocytic alveolitis and bronchiolitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Acremonium↗
PubMed1991

[Slowly progressive fluent aphasia--clinical features and an imaging study including MRI, SPECT and PET].

Three cases of slowly progressive fluent aphasia were presented. In all it began with word amnesia or stuttering, and in one to five years impairment of auditory comprehension, and reading and writing difficulties with kanji (Japanese morphograms) appeared. The neuropsychological and radiological findings were as follows: Case 1: a right-handed 65-year-old man showed severe fluent aphasia (the Western Aphasia Battery profile was rated as corresponding to Wernicke's aphasia but his score on the Token test was too high for Wernicke's aphasia) and memory disturbance. Cortical atrophy was prominent in the left temporal and parietal lobes. Hypoperfusion was evident in the bilateral anterior temporal region, suggesting the diagnosis of Pick's disease. Case 2: a right-handed 42-year-old man presented amnesic aphasia with buccofacial and ideomotor apraxia. The left frontal, temporal and parietal lobes were all atrophic. Hypoperfusion was marked in the left perisylvian and temporo-parietal regions, being similar to the pattern of Mesulam's slowly progressive aphasia. Case 3: a right-handed 55-year-old man with amnesic aphasia. Left-side dominant cortical atrophy involved the frontal, temporal and parietal lobes. The metabolic rate was lower in the left anterior temporal lobe, compatible with the finding in Pick's disease. The common clinical features of these patients were selective deficits in vocabulary, resulting in impairment of confrontation naming, and auditory comprehension. They sometimes could not recognize things even when they were told their names; case 1 could not even point to objects on command, while their syntactic comprehension was well preserved.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Marchiafava-Bignami disease with symptoms of the motor impersistence and unilateral hemispatial neglect].

Machiafava-Bignami disease (MBD) occurs in the alcoholic patients. It is characterized clinically by interhemispheric disconnection syndrome, resulting from demyelination and necrosis of the corpus callosum. We performed a neuropsychological study of an alcoholic patient, diagnosed as MBD by X-ray computed tomography (CT) and magnetic resonance imaging (MRI). 123I IMP-SPECT of the patient revealed the reduction of the blood flow in both cerebral hemispheres without laterality though both the X-ray CT and MRI showed no abnormality in the cerebral hemispheres. In neuropsychological studies, we observed not only interhemispheric disconnection syndrome such as an unilateral left agraphia and left apraxia but also left hemispatial neglect demonstrated in right-hand performance and motor impersistence. Because there were no abnormal lesions in the right hemisphere, these symptoms might be attributable to the lesions of corpus callosum.

Alcoholism↗
PubMed1991

[Prenatal evaluation of the platelet counts in the fetuses and the neonates of the mothers complicated with idiopathic thrombocytopenic purpura].

We investigated 25 pregnancies with ITP. The results were as follows. 1. The platelet counts of the maternal blood just before delivery were not correlated with those of the cord blood. 2. It was suggested that the maternal PAIgG value just before delivery could foretell the onset of neonatal thrombocytopenic purpura. 3. The platelet counts in fetal scalp blood were correlated with those of the cord blood, but falsely lower platelet counts were found in the fetal scalp samples. 4. We saw 5 cases of percutaneous umbilical blood sampling (PUBS) in pregnancies with ITP. PUBS was found to be a useful and safe method. The indications for PUBS and fetal platelet transfusion in pregnancy with ITP are discussed.

Cesarean Section↗