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Biomedical subjects

M Konishi

Publications and source records attributed to M Konishi.

At least 127 records · Page 7Linked to original sources
PubMed1998

[Two cases of Achromobacter xylosoxidans sepsis].

Achromobacter xylosoxidans is a gram-negative bacterium whose natural habitat has not been clearly defined. It has been isolated from ear discharge and the large intestine of humans and from various hospital or environmental water sources. Infection with A. xylosoxidans in humans has been documented, and resulting illnesses include meningitis, pneumonia, cholecystitis, peritonitis and urinary tract infection. Bacteremia due to A. xylosoxidans is rare, and little information on treatment is available. Two cases of bacteremia due to A. xylosoxidans in patients with hemapoietic malignancies are reported herein. Case 1 involved a 70-yr. male whose clinical diagnosis was IgA lambda-type plasmacytoma. Case 2 involved 72-yr. male whose clinical diagnosis was acute lymphatic leukemia (L2). Both patients had been catheterized. Neutropenia was noted and the white blood cell counts were 20/microliter in case 1 and 35/microliter in case 2 when A. xylosoxidans was isolated from the blood culture. We suggest that bacteremia due to A. xylosoxidans may have been related to the presence of the catheter and neutropenia.

Aged↗
PubMed1998

[A clinical study of respiratory infection isolating non-pathogenic Neisseria by transtracheal aspiration].

Neisseria species other than N. meningitidis and N. gonorrhoeae are generally regarded as commensal bacterial flora of the oropharynx, and little is known regarding cases of these non-pathogenic Neisseria species in the lower respiratory tract. We clinically examined respiratory tract infections from which non-pathogenic Neisseria species were isolated by transtracheal aspiration (TTA). The incidence of non-pathogenic Neisseria isolated was 54 (15.7%) out of 344 episodes of respiratory tract infections with isolated microorganisms from TTA, and was 17.6%, 15.8%, 14.3% for pneumonia, acute bronchitis, and chronic lower respiratory tract infection, respectively. All 54 episodes were isolated with other microorganisms such as alpha-Streptococcus spp. (75.9%), Haemophilus influenzae (25.9%) and anaerobics (22.2%). The isolation ratio according to the age group increased at 45 years of age or more, but did not increase with the advance of age. Predisposing factors were identified such as overt aspiration, iatrogenic procedure and heavy smoking. Cases without overt aspiration that had fevers of 38 degrees C or more or hypoxemia of less than PaO2 70 torr when detecting non-pathogenic Neisseria were observed more frequently in the aged than the non-aged. The findings suggest the detection of non-pathogenic Neisseria by TTA is influenced by the host state that the fall of microorganisms from the upper to lower respiratory tract cannot be defended or excluded by mucociliary transportation disorder due to underlying disease and smoking, or deterioration of physical status other than overt or silent aspiration.

Age Factors↗
PubMed1998

[Clinical evaluation of lung abscess diagnosed by transtracheal aspiration].

We have diagnosed lung abscess according to findings of infiltration with cavity formation on chest X-ray and/or CT-scan and pathogens isolated from transtracheal aspirates. We evaluated the clinical features of 20 patients with lung abscess (18 males and 2 females, mean age; 54.3 years). Diabetus mellitus and periodontal diseases were prominent underlying diseases in patients with lung abscess. Cough was complained in 13 patients, chest or back pain in 9, purulent sputum in 8 and hemosputum in 5 when the patients admitted to our hospital. A temperature higher than 38 degrees C was present in 12 patients but temperature les than 37 degrees C in 2. Multiple microorganisms were cultured from TTA in 15 patients. A mean of 2.7 bacterial species per patient was isolated, aerobes alone being isolated in 2 patients, anaerobes alone in 3, and mixed aerobic and anaerobic isolates in 10. Seventeen strains of aerobes and 35 of anaerobes were isolated. Major pathogens were Streptococcus pneumoniae, Streptococcus intermedius and other in aerobes, and Peptostreptococcus micros, Fusobacterium necrophorum, Prevotella melaninogenica and others in anaerobes. Abnormality of chest X-ray was located on the right upper lobe in 6 patients, the right lower lobe in 6, the left upper lobe in 6, the left lower lobe in 4 and the right middle lobe in 1. All patients were cured only by treatment of antimicrobial agents, but cavity formation on chest X-ray remained in 4 patients after the treatment.

Adult↗
PubMed1998

[Bacillus cereus septicemia in a patient with severe aplastic anemia].

A 78-year-old female was admitted with complaints of malaise and fatigue in the legs. The patient was diagnosed as severe aplastic anemia and treatment was started with metenolone and steroid pulse therapy. Administration of antibiotics and granulocyte-colony stimulating factor which led to a resolution of the high fever. About four months after admission, the patient developed vomiting and abdominal pain with a spiking fever. The next day after suddenly losing consciousness, she died. B. cereus was isolated from blood cultures. Autopsy specimens of the liver, cardiac muscle and lung showed changes due to B. cereus. This pathogen is widely distributed in nature. We should not overlook B. cereus as a contamination, but rather should consider it a potential pathogen in immunocompromised hosts, when it is isolated from blood cultures.

Aged↗
PubMed1998

[Clinical analysis of patients with sepsis--comparison between underlying diseases].

We evaluated the clinical data in 83 patients with sepsis, which was diagnosed by both Bone's definition of sepsis and positive isolates from blood culture, according to their underlying diseases. This study enrolled a total of 117 septic episodes in 83 patients (57 males and 26 females, mean age: 52.0 years). We classified 3 groups, including hematological malignancies (46 patients, 72 episodes), solid malignant tumors (23 patients, 25 episodes) and non-malignancies (14 patients, 20 episodes), by the underlying diseases. Of the total number of isolates from blood culture, 53.0% were single gram-positive bacteria, 33.3% were single gram-negative bacteria, 7.7% were single fungus and 6.0% were polymicrobial organisms. In addition, coagulase negative staphylococci was isolated most often in patients with hematological malignancies. Sepsis was often caused by infectious focuses of hemorrhoid, stomatitis or intravenous catheter in patients with hematological malignancies, by pneumonia in patients with solid malignant tumors and by urinary tract infection in patients with non-malignancies. Mortality of sepsis in patients with solid malignant tumors (48%) was highest in 3 groups. Septic patients, who were complicated with shock and/or DIC, has poor prognosis in all groups. Serum albumin level was significantly lower in dead patients than patients who survived. These results suggest that clinical features may be different according to the underlying diseases of patients with sepsis.

Aged↗
PubMed1998

[An epidemiological investigation for MRSA and PRSP in Kinki area. Kinki Infection Working Group].

Recent trends in the development of resistance of the Staphylococcus aureus and Streptococcus pneumoniae to antibiotics were investigated, using a questionnaire delivered to participants at a meeting of the Kinki District Society of Infections. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 55.4% of all isolated S. aureus, and more than 80% of MRSA was detected within hospitals. In outpatients, MRSA was often detected in pus, while in hospitalized patients, MRSA was often detected in sputum. Further, MRSA was accompanied by some other organisms (most frequently Pseudomonas aeruginosa) in 64.7% of MRSA positive patients. The sensitivity of MRSA to vancomycin (VCM) was 100%, to sulfamethoxazole-trimethoprim (ST) 99.2%, and to arbekacin, 98.6%. In contrast, Penicillin-resistant Streptococcus pneumoniae (PRSP) accounted for 42.4% of all isolates of Streptococcus pneumoniae. About 50% of PRSP was detected in out-patients. For both hospitalized patients and outpatients, PRSP was most frequently detected in sputum. PRSP was accompanied by some other organisms (most frequently Haemophilus influenzae) in 49.3% of PRSP positive patients, PRSP had high sensitivity to cephems, carbapenems and VCM.

Aminoglycosides↗
PubMed1998

Severe form of juvenile corneal stromal dystrophy with homozygous R124H mutation in the keratoepithelin gene in five Japanese patients.

AIM: To confirm the mutation of the keratoepithelin gene in patients with a severe form of superficial juvenile granular corneal dystrophy (GCD). METHODS: Five Japanese probands in whom GCD was diagnosed after histopathological examination and who developed severe manifestations of GCD in their first decade of life were investigated. Other affected family members of two probands were also examined. All probands were the offspring of consanguineous parents. DNA was extracted from their peripheral blood leucocytes and mutational analysis of the gene was performed by the polymerase chain reaction and direct sequencing. RESULTS: Four of the five probands underwent their first keratectomy or keratoplasty in their teens and subsequently underwent a second or third keratoplasty. Each proband had a homozygous G-->A transition at codon 124, replacing Arg-->His, of the keratoepithelin gene. Their moderately affected family members were heterozygous for the mutation. CONCLUSIONS: This finding suggests that the severity of the corneal phenotype depends on the dose effect of the mutant gene.

Adult↗
PubMed1998

Aging and immune response to exercise.

Human immune function undergoes adverse changes with aging. The T cells, which have a central role in cellular immunity, show the largest age-related differences in distribution and function, with thymus involution as the apparent underlying cause. The immune responses to acute exercise and training have not been studied extensively in the elderly. The natural killer (NK) cell response to a single exercise challenge is normal in older individuals, but immediately after exercise the elderly subjects manifest less suppression of phytohemagglutinin (PHA)-induced lymphocyte proliferation than younger individuals. In contrast, a strenuous exercise seems to induce a more sustained postexercise suppression of cellular immunity in older individuals than in their young peers. A few cross-sectional comparisons of immune status between physically fit elderly individuals and young sedentary controls suggest that habitual physical activity may enhance NK cell activity, checking certain aspects of the age-related decline in T cell function, such as reduced mitogenesis in response to plant lectins and decreases in the production of certain types of cytokine. The clinical implications, however, remain to be clarified by future study.

Adult↗
PubMed1998

Management of malignant ovarian tumors in young women. 21 nulliparous cases.

To evaluate the management of malignant ovarian tumors in young women who wish to maintain fertility, we retrospectively reviewed ovarian malignancies in 21 young women who were both nulliparous and under 40 years of age. With stage 1a disease, all 9 patients were treated with conservative surgical therapies, and all of them are still alive, irrespective of histological type. With stage 1c disease, 5 (83%) of 6 patients were treated with conservative surgical therapies. Among them, 2 patients with epithelial tumors, who were treated with conservative surgical therapies and potent cis-diamminedichloroplatinum (CDDP)-based combined chemotherapies, are still alive. Furthermore, one of them had a successful pregnancy. On the other hand, 3 out of 4 patients with nonepithelial tumors were treated with conservative surgical therapies. However, 2 (67%) out of 3 died; both of them were treated with non-CDDP-based chemotherapy. In 6 patients with disease beyond stage 2, 4 (67%) were treated with radical surgical therapies, but 2 (33%) were treated with conservative surgery and CDDP-based combined chemotherapy, one of which was followed by a successful pregnancy in spite of nonepithelial tumor. As above, we could obtain some successful pregnancies in cases beyond stage 1c after conservative surgery by adding definite CDDP-based combined chemotherapy. However, we must carefully select the patients with nonepithelial tumors for conservative therapy by adding definite CDDP-based combined chemotherapy and inform them of the risks of therapy.

Adolescent↗
PubMed1998

Effects of a long-term hypertension control program on stroke incidence and prevalence in a rural community in northeastern Japan.

BACKGROUND AND PURPOSE: Although randomized clinical trials have demonstrated the benefit of antihypertensive treatment in preventing stroke, the effectiveness of community-based programs is largely unknown. We investigated long-term community-based prevention activities. METHODS: In rural northeastern Japan, people aged > or = 30 years numbered 3219 in the full intervention community and 1468 in the minimal intervention community in 1965. Systematic blood pressure screening and health education began in 1963. Stroke was registered through 1987. RESULTS: More than 80% of people aged 40 to 69 years were screened in both communities in the 1960s. One community charged for screening services after 1968, whereas the other community intensified intervention; subsequently, screening rates and the follow-up of hypertensive individuals declined in the minimal intervention community, especially in men. In men, stroke incidence declined more (P < 0.001) in the full intervention (42% in the period 1970 to 1975, 53% in the period 1976 to 1981, and 75% in the period 1982 to 1987) than in the minimal intervention community (5% increase, 20% decrease, and 29% decrease, respectively); in women, the stroke incidence declined about 45% to 65% in both communities. Changes in stroke prevalence paralleled those in stroke incidence. Trends in systolic blood pressure levels tend to explain the differential stroke rates in men. CONCLUSIONS: Delivery of hypertension control services through intensive, free, community-wide screening and health education was effective in prevention of stroke for men in a community.

Adult↗
PubMed1998

Cytoplasmic free concentrations of Ca2+ and Mg2+ in skeletal muscle fibers at rest and during contraction.

This review summarizes estimates for cytoplasmic-free concentrations of Ca2+ ([Ca2+]i) and Mg2+ ([Mg2+]i) at rest and during contraction of skeletal muscles, from which substantial quantitative information about them has been accumulated. Although the estimates of resting [Ca2+]i in the literature widely differ, which is because of the variety of difficulties related to different methodologies used, recent studies suggest that estimates of resting [Ca2+]i of approximately 0.05-0.1 microM are likely to be correct. Following action potential propagation, the Ca2+ release from the sarcoplasmic reticulum causes a transient rise of [Ca2+]i (Ca2+ transient). The large peak amplitude and brief time course of the Ca2+ transients have been established only recently by studies with low-affinity Ca2+ indicators developed in the past decade. These technical improvements in [Ca2+]i measurements have made it possible to study relationships between [Ca2+]i and force in intact muscle fibers. In the second part of this review, various estimates of [Mg2+]i in the resting muscle are discussed. Relatively recent estimates of the [Mg2+]i level appear to be about 1.0 mM. Using the current knowledge of concentrations and reaction properties of intracellular Ca2+-Mg2+ binding sites, we constructed a model for dynamic Mg2+ movement following Ca2+ transients. The model predicts that with a train of action potentials, the sustained rise of [Ca2+]i produces an elevation of [Mg2+]i of about 200 microM.

Animals↗
PubMed1998

Estimation of age from the femur of Japanese cadavers.

This study was designed to estimate the age at the death of cadavers by histomorphometry of the femur. Samples from 72 Japanese males from 43 days to 92 years old and 26 females from 2 to 88 years old were used. The thickness of sections was adjusted to 50-70 microns by grinding with sandpaper. The sections were not any decalcified. They were stained with Villanueva's bone staining powder and thionin dye. The microradiographs of the sections were obtained by a soft x-ray apparatus. The area, length, width, and perimeter of the perfect osteon and haversian canal were measured. The type II osteon number, osteon fragment number, and area of triangle were also determined. These parameters were examined by an image analyzer. The parameters of the osteon showed a high correlation coefficient with age (magnitude of r > or = 0.77), whereas those of the haversian canal were low (magnitude of r < or = 0.11). All parameters were subjected to multiple regression analysis for producing a multiple regression equation of age estimation. For the stepwise selection method, the perimeter of osteon, length of the haversian canal, and osteon fragment number were selected for the equation. Their multiple r2 and standard error of estimation were 0.8874 and 6.39, respectively. For the forward selection method, in addition to the above items, three parameters, the length of osteon, area of triangle, and width of osteon, were selected. Their multiple r2 and standard error of estimation were 0.9484 and 4.884, respectively. Bone staining was useful to clarify the demarcation between osteon and fragment, leading to increased accuracy of age estimation. However, precisely estimating age for the entire range from birth to 90 years was difficult.

Adult↗
PubMed1998

[Exposure to tobacco smoke in a Japanese urban population. An analysis using biochemical markers of smoking].

An epidemiological study in an urban population was conducted to investigate exposure to tobacco smoke using two biochemical markers of smoking. In 1993 and 1994, expired air carbon monoxide (EACO) concentrations were determined with a small portable CO monitor for 4,619 subjects aged 30 and over, who had been randomly selected from residents of S-city in Osaka Pref, and who had received a health examination for cardiovascular disease at the National Cardiovascular Center. Urinary cotinine (UCOT) concentrations were determined using gas chromatography for 480 subjects, who were nonsmokers, and who had received a health examination during Sep. and Nov. in 1994. They also completed a questionnaire about smoking habits and potential of passive smoking. In this study smoking prevalences were 45% in men and 11% in women according to the questionnaire. Among nonsmokers 55% of men and 46% of women reported some degree of exposure to tobacco smoke. The EACO levels were related to the number of cigarettes smoked per day in a dose-response fashion. The time elapsed since last smoked and the usual depth of inhalation, in addition to the number of cigarettes, had effects to EACO level. The optimal EACO cut-off points selected to differentiate smokers and nonsmokers were between 6 and 7 ppm for men, and 5 and 6 ppm for women with a sensitivity and a specificity of about 90%. The hours spent with tobacco smoke at home, whether there was a smoking spouse or not, and the time elapsed since last inhalation of smoke affected EACO level in nonsmokers. The frequency of going to an amusement place, a bar or a restaurant, and the hours spent with tobacco smoke in a work place had effects on UCOT level in non-smokers. The proper use of biochemical markers for tobacco smoke may be of value in developing more effective strategies for smoking problems control.

Adult↗
PubMed1998

[Effect of clarithromycin treatment of natural killer cell activity in patients with advanced non-small cell lung cancer].

The treatment of a 14-membered ring macrolide, clarithromycin (CAM), prolongs the survival time of patients with unresectable nonsmall cell lung cancer, and improves the host factor. As we previously reported, one of the underlying mechanisms is that the treatment of CAM increases the bioactivity of interleukin-12 (IL-12). In the present study, we administered CAM to murine lung cancer treatment models with Lewis lung carcinoma and to 18 patients with unresectable non-small lung cancer whose anticancer treatment had been terminated. The timing of CAM administration was examined and the time course of NK activity was measured. In the murine lung cancer treatment models, administration of CAM 7 days after anticancer chemotherapy more strongly inhibited the tumor growth and more rapidly and significantly increased NK activity, compared to the concomitant use of CAM with an anticancer chemotherapy. In humans, the NK activity which had decreased after anticancer treatment, tended to be increased after one month of treatment with CAM (p = 0.06). One month of treatment with CAM significantly increased the NK activity (p < 0.05) of the following subjects: patients with stage III in the clinical stages, patients with squamous cell carcinoma, patients who had received radiotherapy alone as pretreatment therapy, and patients whose pretreatment therapy effect was partial response (PR). We conjectured that increasing NK activity was one of the underlying mechanisms of the macrobiotic effect of CAM. CAM was especially effective for patients in the early clinical stages and patients who responded well to pretreatment therapy. Murine lung cancer models showed that non-concomitant use of CAM with anticancer chemotherapy was more effective.

Aged↗
PubMed1997

Drastic genetic instability of tumors and normal tissues in Turcot syndrome.

Turcot syndrome is characterized by an association of malignant brain tumors and colon cancer developing in the patient's teens. Since the mechanism of carcinogenesis in Turcot syndrome is still unclear, we analysed genetic changes in tumors from a Turcot patient with no family history of the condition. All tumors, including one astrocytoma, three colon carcinomas, and two colon adenomas, exhibited severe replication error (RER), and all colon tumors showed somatic mutations at repeated regions of TGFbetaRII, E2F-4, hMSH3, and/or hMSH6 genes. Somatic APC mutations were detected in three of three colon carcinomas, and somatic p53 mutations were detected in the astrocytoma and two of three colon carcinomas, both of which showed two mutations without allele loss. We also found that normal colon mucosa, normal skin fibroblasts and normal brain tissue from this patient showed respective high frequencies of RER, in contrast to usual HNPCC patients in which RER was very rare in normal tissues. These results suggest that extreme DNA instability in normal tissues causes the early development of multiple cancer in Turcot syndrome. A missense mutation (GAG to AAG) at codon 705 of hPMS2 gene was detected in one allele of this patient, which was inherited from his mother without tumors. Additional unknown germline mutation may contribute to the genetic instability in normal tissues.

Adenocarcinoma↗