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Biomedical subjects

M Motomiya

Publications and source records attributed to M Motomiya.

At least 73 records · Page 4Linked to original sources
PubMed1990

Does a beta 2-stimulator really facilitate mucociliary transport in the human lungs in vivo? A study with procaterol.

The purpose was to study whether procaterol, a beta 2-stimulator, facilitated mucociliary transport on the ciliated airways in the human lungs. From immediately after inhalation of [99mTc]albumin aerosol, radioactivity of the thorax was continuously measured anteriorly by a gamma camera with the examinee in the supine position; the data were sequentially stored in a computer in 10-s frame mode. Three puffs (30 micrograms) of procaterol were inhaled from a metered dose inhaler at 60 min in the same supine position, and measurement of radioactivity was continued for 30 min more. Spirometry was performed before and after the measurement of radioactivity. A group of 8 normal subjects and 34 patients with various lung diseases, including 6 with bronchial asthma in remission, were studied. In addition to observation of mucus transport on the large airways by radioaerosol inhalation lung cinescintigraphy, the time-activity curve from the right lung was evaluated and the quantitative parameters for evaluating mucociliary clearance were calculated for the right lung. Following inhalation of procaterol, there were neither significant acceleration in mucus transport on the large airways by cinescintigraphy nor significant changes in the slope of time-activity curves. Quantitative parameters did not show any significant changes either, although spirometry indicated significant bronchodilation. We conclude that three puffs of inhaled procaterol neither necessarily accelerate mucus transport nor facilitate mucociliary clearance in the human lung.

Administration, Inhalation↗
PubMed1990

Distribution of smooth muscles along the bronchial tree. A morphometric study of ordinary autopsy lungs.

A morphometric pilot study was performed on airway smooth muscle in 20 autopsy lungs with no history of chronic obstructive pulmonary disease (COPD) to establish a basis for the systematic analysis of the behavior of airway muscles in bronchial asthma or COPD. A total of 514 samples of cross-sectioned airways were taken from these lungs, covering as uniformly as possible the whole range from segmental bronchi to terminal bronchioles. In each airway, the perimeter length L of the epithelial basement membrane and the area S of mural smooth muscles were measured using a digital image analyzer, and the thickness D of smooth muscles and the radius R were determined in a standardized state in which the airway was stretched into a circle without changing L or S. On bilogarithmic coordinates, D was found to correlate significantly with R not only in individual cases but also in the total pooled data. D/R, the relative thickness of muscles, increased toward the periphery of the airways. In a theoretical application of Laplace's law to the physical conditions dominating the airway wall, this tendency in D/R suggests that the activity of airflow regulation is highest in terminal airways.

Adult↗
PubMed1990

Hyperreactive site in the airway tree of asthmatic patients revealed by thickening of bronchial muscles. A morphometric study.

Under the assumption that the more hyperreactive the bronchial muscles are, the greater their work hypertrophy, we analyzed the distribution of hypertrophic smooth muscles along airways to see where in the bronchial tree asthmatic constrictions mainly occur. Autopsy lungs from 16 patients with bronchial asthma, 13 with other COPDs, and 20 controls were submitted to morphometry of the bronchial muscles. In microscopic slides, cross sections of airways were taken from the segmental bronchi to the terminal bronchioles. The perimeter length L of the basement membrane and the area S of muscles were measured, and the anatomic radius R and the muscular thickness D were calculated in a standardized circular state, in which the basement membrane was stretched into a circle without changing L or S. On bilogarithmic coordinates of D and R on which data from the asthmatics were pooled, it was shown that hypertrophy of muscles was the most pronounced in larger bronchi where constriction was most likely to occur. Closer analysis of patients, however, revealed that besides this typical pattern, which we designated Type I asthma, there was a group of patients (Type II) in whom hypertrophy involved the entire range of airways, including the bronchioles, suggesting that the site of asthmatic response varies among patients. In nonasthmatic patients with COPD, only mild hypertrophy of muscles was found in the large airways, despite the presence of obstructive lesions mainly in the small airways.

Adult↗
PubMed1990

[Radioaerosol inhalation lung imaging using technegas].

Technegas generator using 99mTc-pertechnetate was tested on 4 normal subjects and 31 patients with various chest diseases including bronchogenic carcinoma, pneumonia, pulmonary tuberculosis, sarcoidosis, and so on. Technegas was inhaled from the RV to the TLC levels through the mouth with the nose clipped followed by breath-holding. Three deep breaths were enough to deposit 37-55.5 MBq (1 to 1.5 mCi) of technegas in the lungs. The average alveolar deposition ratio (ALDR) was 85% and penetration of inhaled technegas to the lung periphery was excellent. "Hot spots" or excessive radioactive deposition were also seen when there was airway obstruction. The former indicated the characteristic as gas and the latter, that as aerosol particles. Because of the large ALDR's the timing for imaging lungs after inhalation of technegas most likely indicated the intrapulmonary sites of effective ventilation, because respective inhalation and perfusion lung images resembled each other very much. The disadvantage of technegas was that it was anoxic right after generation.

Administration, Inhalation↗
PubMed1990

[Therapeutic efficacy of miconazole on deep-seated fungal infections in the respiratory tract system].

We evaluated the therapeutic efficacy of miconazole (MCZ, Florid-F inj.), a new antifungal agent for parenteral use, in deep-seated fungal infections of respiratory tract system. A daily dose of 400-1,800 mg of MCZ was given intravenously for 12-38 days (mean: 23.4 days) to 7 patients: 2 patients with pulmonary aspergillosis, 1 patient with bronchial aspergillosis, 1 patient with pulmonary candidiasis and 3 patients with candidemia. One additional patient with pulmonary aspergillosis received three instillations of 20 mg of MCZ into the thoracic cavity. The clinical effects were excellent in 1, good in 4 and poor in 3 patients. The efficacy rate was 100% in 5 cases with respiratory fungal infections but 3 cases with candidemia did not respond well to the treatment. Four strains each of Aspergillus sp. and Candida sp. were identified as causative organisms. Seven of the 8 strains were eradicated by administration of MCZ. Side effects observed were irritation and heat in a leg in 1 patient, hyperlipoidemia in 2 patients and eosinophilia in 1 patient. The adverse reactions disappeared after the completion of the therapy. From the above results, we conclude that MCZ is one of the most useful antifungal agents for parenteral use as a first choice on deep-seated fungal infections in the respiratory tract.

Adult↗
PubMed1990

[Studies on respiratory infections in primary care clinic (II). Distribution and antibiotic sensitivity to 45 agents of bacteria isolated from patients with respiratory infections visiting a doctor in private practice].

The bacteriology of the isolates from the sputum or the throat swab of patients with respiratory infections visiting a doctor in private practice in Sendai city during the period from March in 1988 to February in 1989 was documented, and their sensitivity to 45 antimicrobial agents was determined. Of the 568 patients, 514 cases had acute pharyngitis, 8 cases each had acute tonsillitis and acute bronchitis, 7 cases were acute pneumonia, 6 cases had herpangina, 18 cases had hand-foot-mouth disease with the signs of respiratory infections, 5 cases had varicella with the signs of respiratory infections and 2 cases were mumps with the signs of respiratory infections. Three hundred strains of potential (greater than or equal to 10(7) CFU/ml) pathogens were recovered from 293 of the 568 cases, which consisted of 124 strains of Haemophilus influenzae, 58 strains of Streptococcus pneumoniae, 45 strains of Staphylococcus aureus, 26 strains of Branhamella catarrhalis, 25 strains of Streptococcus pyogenes, 9 strains of Klebsiella pneumoniae and 13 strains of other species, not including non-fermentile gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter calcoaceticus. Staphylococcus aureus and other strains were documented simultaneously in 6 out of 7 cases in which multi-organisms were recovered. Many strains of Staphylococcus aureus were isolated from young patients throughout the year. On the other hand many strains of Branhamella catarrhalis were isolated from elderly patients in winter. The sensitivity of 45 antimicrobial agents of 231 of 300 strains was determined by sensitivity disks (EIKEN, Japan). No strain of the Haemophilus influenzae in this study was resistant to ampicillin. None of the Streptococcus pneumoniae and Streptococcus pyogenes was resistant to ampicillin or cefazolin. None of the Staphylococcus aureus was resistant to cloxacillin, cefazolin, gentamicin or ofloxacin. We conclude from the above results that antibiotic-resistant strains are found presumably only in a very few cases in primary care clinic.

Anti-Bacterial Agents↗
PubMed1990

[Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; the detection of impaired vasodilatory capacity with 133Xe SPECT and acetazolamide (Diamox) test].

To evaluate the efficacy of 133Xe SPECT and Diamox test, for selecting patients with hemodynamic compromise, tests using 133Xe inhalation method and single photon emission computed tomography (SPECT) with acetazolamide (Diamox) were performed in twenty-three patients with chronic cerebral ischemia, before and after extracranial-intracranial bypass surgery or carotid-endarterectomy. All patients complained of TIA, RIND, or minor completed stroke, and cerebral angiography of all patients demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery. Cerebral blood flow (CBF) was also measured 15 minutes after intravenous administration of 10-12 mg/kg Diamox, which is known as a cerebral vasodilatory agent (Diamox test). Our results revealed that all patients could be divided into four types according to the findings of their resting rCBF and Diamox reactivity. The patients who had normal resting rCBF and normal Diamox reactivity (type 1) were considered to have well-developed collateral circulation and normal cerebral perfusion pressure (CPP) in spite of severe occlusive lesions in the carotid system. Moderate vasodilatation due to reduced CPP was considered to occur in patients who had normal resting rCBF and decreased Diamox reactivity (type 2). The resting rCBF remained unchanged, but Diamox reactivity improved to the normal range after surgery in the patients of type 2 (p less than 0.01), which indicated the improvement of CPP and the resolution of the autoregulatory vasodilatation. Maximum vasodilatation or dysautoregulation was considered to occur due to the inadequate collateral flow and the severely reduced CPP in patients whose findings revealed decrease in the resting rCBF and impaired Diamox reactivity (type 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetazolamide↗
PubMed1990

Mucociliary clearance and transport in bronchiectasis: global and regional assessment.

Global and regional mucociliary clearance and transport in the lungs was studied in 20 patients with bronchiectasis by radioaerosol inhalation lung cine-scintigraphy and the quantitative analysis following inhalation of ultrasonically-generated 99mTc-tagged human serum albumin aerosol (mass median diameter; 1.93 microns with geometric s.d. of 1.52). In bronchiectatic lung regions, deposition of inhaled aerosol was diminished or inhomogeneous. Transport of inhaled radioactivity from the bronchiectatic regions was deranged in 95% of the patients (19/20). The following abnormal mucous transport patterns were regionally observed; stasis in 12 of the 20 patients (12/20), regurgitation or reversed transport in 14/20, straying in 8/20, spiral or zigzag transport in 1/20, and/or various combinations of these four abnormal transport patterns. When coughs occurred, regurgitation and stray became more marked in the bronchiectatic regions. These regional abnormalities in mucociliary transport seem to be responsible for the development of infections and hemoptysis in the bronchiectatic regions.

Administration, Inhalation↗
PubMed1990

[Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; measurement of cerebral blood volume (CBV) with 99mTc-RBC SPECT].

To evaluate the efficacy of tests for selecting patients with hemodynamic compromise, measurement of cerebral blood volume (CBV) with 99mTc-RBC single photon emission computed tomography (SPECT) was performed in thirteen patients with occlusive cerebrovascular disease, and was compared with results obtained by 133Xe SPECT and acetazolamide (Diamox) test. All patients in our study suffered TIA, RIND, or minor complete stroke. Cerebral angiography demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery, although plain CT scan or MRI revealed no or, if any, only localized infarcted lesions. Regional cerebral blood volume (rCBV) was measured with 99mTc-RBC SPECT and regional cerebral blood flow (rCBF) was measured with 133Xe SPECT before and after intravenous injection of 10 - 12 mg/kg acetazolamide (Diamox). Our results suggest that the ipsilateral rCBV/rCBF (mean transit time) is a more sensitive index of the cerebral perfusion reserve than the use of only rCBV or rCBF of the ipsilateral hemisphere. Also, the ipsilateral rCBV/rCBF is significantly correlated (r = -0.72) with the Diamox reactivity of rCBF, which is considered to represent the cerebral vasodilatory capacity in patients with chronic cerebral ischemia. Postoperative SPECT study revealed remarkable improvement of ipsilateral rCBV/rCBF and Diamox reactivity in four patients who underwent EC/IC bypass surgery to improve the hemodynamic compromise. In conclusion, our results suggest that the measurement of rCBV/rCBF with 133Xe SPECT and 99mTc-RBC SPECT is useful for detecting the hemodynamic compromise in patients with occlusive cerebrovascular disease.

Acetazolamide↗
PubMed1990

[Therapeutic efficacy of ceftibuten in chronic respiratory tract infections].

We evaluated the therapeutic efficacy of ceftibuten (CETB, 7432-S), a new cephem antibiotic for oral use, in chronic respiratory tract infections. A daily dose of 400 mg (b.i.d.: 15 cases) or 600 mg (t.i.d.: 5 cases) of CETB was given orally for 3-14 days (mean: 10.6 days) to 20 patients: 9 with infected bronchiectasis, 3 with infection supervened on pulmonary emphysema, 3 with acute pneumonia (supervened on bronchiectasis in 2 of 3 cases), 2 with infected bronchial asthma, 1 each with infection supervened on old pulmonary tuberculosis, chronic bronchitis and pulmonary fibrosis. The clinical effects were excellent in 3, good in 11, fair in 3 and poor in 3. Eighteen strains were identified as causative organisms. Eight of 15 strains for which bacteriological responses were evaluable were eradicated by the use of CETB. Eosinophilia in 2 patients and an elevation of S-GPT value was observed in 1 patient. These adverse reactions disappeared after the completion of the therapy. From the above results, we conclude that CETB is one of the most useful antibiotics for oral use as a first choice in chronic respiratory tract infections.

Adult↗
PubMed1989

[Studies on respiratory infections in the field of primary care (I). Correlation between viral infection and secondary bacterial infection in patients visiting a doctor in private practice].

We attempted to find out whether there is a correlation between viral infection and secondary bacterial infection on the basis of the analysis of the results of the culture of virus and bacteria in the same specimen from the throat swabs of 95 patients who had an acute upper respiratory inflammation when they visited a doctor in private practice in Sendai city during the epidemic caused by influenza virus. Viral culture was performed by a microplate-method devised originally by Numazaki. The influenza virus was recovered from 56 cases (59%) consisting of 43 cases of type A (Hong-Kong) and 13 cases of type B. From 73 cases, (77%), 79 strains of possibly pathogenic bacteria were recovered, consisting of 43 strains of H. influenzae, 18 strains of S. aureus, seven strains of S. pneumoniae, four strains each of C. freundii and S. liquefaciens and one strain each of beta-haemolytic Streptococcus and B. catarrhalis. The incidence of positive culture of both virus and possibly pathogenic bacteria was high already at the early stage (2-3 days) of the disease. We found no correlation between the type of virus and the species of the microbial isolates. There was no difference in the incidence of positive bacterial culture in relation to age group. We suggest that a secondary bacterial infection occurs already at the early stage of the disease after viral infection because the incidence of positive culture of possibly pathogenic bacteria was high at the above stage.

Adolescent↗
PubMed1989

Establishment of an etoposide (VP-16)-resistant subline of THP-1 human monocytic leukemia cell line.

A VP-16-resistant subline was established from THP-1 human monocytic leukemia cells by subculturing in stepwise increasing concentrations of the drug. The resistant cells (THP-1/E) were capable of sustaining continuous growth in 1.0 microgram/ml VP-16. The 50% inhibition dose (IC50) was 1.4 micrograms/ml or a 35-fold of the parent cells. A more than 18-fold IC50 was also obtained with teniposide (VM-26). However, no substantial cross-resistance was observed with 5 other antineoplastic drugs, IC50 values being limited below several times of THP-1.

Cell Division↗
PubMed1989

Normal values for quantitative parameters for evaluation of mucociliary clearance in lungs.

Twenty-eight normal male subjects (13 nonsmokers and 15 smokers, 25 to 76 years of age) inhaled ultrasonically generated 99mTc-tagged human serum albumin aerosol (mass median diameter: 1.93 microns with geometric standard deviation of 1.52) and radioactivity from the thorax was measured continuously from anteriorly in 10 sec frame mode for 90 to 120 min to evaluate mucociliary clearance function in the lungs. Normal values for lung retention ratio (LRR), airway deposition ratio (ADR), airway retention ratio (ARR), airway clearance efficiency (ACE), alveolar deposition ratio (ALDR), and disappearance rate of radioactivity from the ciliated airways (DR) were presented. ALDR was significantly larger in nonsmokers than in smokers. LRR and ARR were significantly smaller and ACE, significantly larger in smokers at any time intervals than in nonsmokers, while ADR and DR were larger in smokers only in the initial 30 min following radioaerosol inhalation was completed. Thereafter there was little difference in ADR and DR between normal smokers and nonsmokers.

Adult↗
PubMed1989

Fatal acute interstitial pneumonia induced by low-dose doxorubicin and vindesine.

A 53-year-old female smoker with small cell carcinoma of the lung with cerebral metastases was initially treated with whole brain radiation with favorable responses. She developed fulminant and fatal interstitial pneumonia following administration of 30 mg of doxorubicin and 6 mg of vindesine. Histopathology revealed that the interstitial pneumonia was compatible with a drug-induced pneumonia.

Acute Disease↗
PubMed1989

Characterization of resistance to VP-16 in human leukemic cell line.

Resistance mechanism was studied in the VP-16-resistant human leukemic cell line (THP-1/E) which was developed by continuous drug exposure. The drug uptake and efflux studies revealed no decrease in net cellular drug accumulation. VP-16-induced DNA single- and double-strand breaks in the whole THP-1/E cells decreased significantly compared to the sensitive counterpart as assessed by alkaline elution methods. Decrease in DNA SSBs was also observable in the isolated nuclei from the THP-1/E cells. The resistance to VP-16 in THP-1/E appeared to be independent of altered membrane permeability, and more likely to be associated with decreased VP-16-mediated DNA cleavage.

Cell Line↗
PubMed1989

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↗
PubMed1989

[Tuberculosis and cancer: primary lung cancer cases after treatment with anti-tuberculous drugs].

Out of 939 primary lung cancer cases (histologically confirmed), 54 cases had received treatment with anti-tuberculous drugs before diagnosis of lung cancer was made. Fifty-one percent of the cases were detected by the mass survey and 55.6% of them were adenocarcinoma. The duration of treatment for tuberculosis was less than 3 months in 63.0% and more than 13 months in 5.6% of the cases. Surgery for lung cancer was performed in 25 cases (46.3%). The ratio of surgical intervention for patients previously treated with anti-tuberculous drugs was not different from that for patients who had received no anti-tuberculous drugs.

Adenocarcinoma↗