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Biomedical subjects

M Sekiguchi

Publications and source records attributed to M Sekiguchi.

At least 217 records · Page 12Linked to original sources

Immunological analysis of organized pneumonia with eosinophilic pleural effusion.

A 73-year-old man developed organized pneumonia with severe right-sided eosinophilic pleural effusion (PE). CD69+ and HLA-DR+ eosinophils in PE were 90 and 31%, respectively, but were undetectable in peripheral blood (PB). CD4+, CD45RA+ (naive) and CD4+, CD45RO+ (memory) cells in PB, PE and bronchoalveolar lavage (BAL) were 10.9, 8.4, 2.5 and 22.7, 38.3 and 16.4%, respectively. CD8+, CD45RA+ (naive) and CD8+, CD45RO+ (memory) cells in PB, PE and BAL were 3.5, 4.7, 1.0, and 8.9, 11.3 and 46.0%, respectively. The concentrations of interleukin-5 (IL-5) and IL-6 in PE were 1,680 and 2,797 pg/ml, respectively; however, these cytokines were undetectable in PB. The patient died 1 month after surgery to remove right thickened pleura. Microscopic findings showed right fibrinous pleuritis and organized pneumonia.

Aged↗

Endothelin-1 and interleukin-8 in high altitude pulmonary oedema.

We present a case of high altitude pulmonary oedema (HAPE) with pulmonary hypertension and polymorphonuclear leucocyte (PMN) accumulation in bronchoalveolar lavage fluid (BALF), which occurred in a 21 year old man. Plasma endothelin-1 (ET-1) and interleukin-8 (IL-8) concentration in BALF were elevated on admission, and returned to normal level at recovery, when the pulmonary artery pressure and the PMN counts in BALF were normal. In addition, E-selectin and intercellular adhesion molecule-1 (ICAM-1) in BALF were also slightly increased on admission. These findings suggest that endothelin-1 is a vasoconstrictor which contributes to the pulmonary hypertension in high altitude pulmonary oedema, and that some of the inflammatory mediators play an important role in chemotaxis and accumulation of polymorphonuclear leucocytes in the development of high altitude pulmonary oedema.

Adult↗

Effect of the 21-aminosteroid U-74006F on antigen-induced bronchoconstriction and bronchoalveolar eosinophilia in allergic sheep.

U-74006F, a non-glucocorticoid 21-aminosteroid, has been developed as an inhibitor of iron-dependent lipid peroxidation. This class of compounds has been shown to prevent antigen-induced eosinophil accumulation in the lungs. In this study, Ascaris-sensitive, "dual-respondent" sheep (showing both immediate (IAR) and late (LAR) asthmatic response) (n = 6) were used to assess the effect of U-74006F on antigen-induced bronchoconstriction and airway inflammation and reactivity 8 h after antigen challenge. Antigen provocation induced dual-phase bronchoconstriction, bronchoalveolar eosinophilia and airway hyperreactivity (AHR) to methacholine. Throughout the experiment, intravenous administration of the drug significantly reduced the IAR and inhibited the LAR along with the inhibition of eosinophil influx, but did not inhibit the increase in airway reactivity observed 8 h after antigen challenge. Post-antigen challenge treatment with U-74006 from 3 h after antigen challenge also significantly reduced the LAR and bronchoalveolar eosinophilia, although the degree of inhibitory effect was milder. The development of the LAR appeared to be dependent on eosinophil recruitment into the lungs. These findings suggest that lipid peroxidation is involved in antigen-induced bronchoconstriction and eosinophil recruitment into the lungs, and that the inhibitor U-74006F may be an effective drug for the treatment of bronchoconstriction and airway inflammation characterized by eosinophil infiltration in asthmatics.

Allergens↗

Acute hypoxic pulmonary vascular response does not accompany plasma endothelin-1 elevation in subjects susceptible to high altitude pulmonary edema.

We have previously shown that high altitude pulmonary edema-susceptible subjects (HAPE-S) have an accentuated pulmonary vascular response to hypoxia. In this study, we investigated the relationship between plasma endothelin-1 (ET-1) levels and the acute hypoxic pulmonary vascular response in HAPE-S and control subjects. In six HAPE-S and seven healthy subjects, we evaluated acceleration time/right ventricular ejection time (AcT/RVET) using Doppler echocardiography, and measured plasma ET-1 levels by radioimmunoassay (RIA) before and after 5 minutes of breathing 10% oxygen. The HAPE-S showed a significantly increased pulmonary vascular response to hypoxia compared with healthy subjects. However, no statistically significant changes of plasma ET-1 levels were observed before and after hypoxia in both groups. We conclude that the increased pulmonary vascular response to acute hypoxia in HAPE-S may not be related to ET-1 release.

Acute Disease↗

Successful treatment of fungus ball in a patient with allergic bronchopulmonary aspergillosis: continuous percutaneous instillation of antifungal agents into the cavity.

A 53-year-old male of allergic bronchopulmonary aspergillosis (ABPA) with pulmonary fungus ball, who had been administered steroid and suffered repeatedly from dyspnea, was treated successfully with continuous percutaneous instillation of antifungal agents into the cavity. Although the pulmonary fungus ball in his left upper lobe was thought to be worsening ABPA, oral and intravenous antifungal agents failed to improve the clinical course. We selected to use continuous instillation of antifungal agents via an indwelling catheter which was inserted percutaneously into the cavity. Although the instillation of fluconazole (FCZ) for four weeks did not alter the process, two-week instillation of amphotericin B (AMPH) caused disappearance of the fungus ball. We measured the plasma concentration of FCZ and AMPH during their instillation into the cavity to ascertain this treatment to be free from side effects pharmacokinetically.

Administration, Inhalation↗

[Use of scintigraph in the diagnosis of pulmonary sequestration].

To evaluate scintigraphic findings in cases of pulmonary sequestration, perfusion lung scintigrams were obtained with Tc-99m macroaggregated albumin, and radionuclide angiocardiograms were obtained with Tc-99m pertechnetate in 5 cases of pulmonary sequestration. Perfusion lung scintigrams showed well-defined, segmental perfusion defects in the left lower lobe adjacent to the diaphragm, including S8, S9, and S10. The radionuclide angiocardiograms delineated abnormal systemic blood flow through the descending aorta to the left lower lobe. Subtraction scintigrams were obtained from two images of different phase in the aortic phase on the radionuclide angiograms; these images showed the abnormal systemic blood flow through the descending aorta more clearly than did the conventional radionuclide angiocardiograms. Thus, perfusion lung scintigrams and radionuclide angiocardiograms may be useful as non-invasive aids in the diagnosis of pulmonary sequestration.

Adult↗

[Two cases of primary Sjögren's syndrome with pulmonary involvement histopathological study of open-lung biopsy specimens].

We report two cases of primary Sjögren's syndrome with pulmonary involvement, in which open lung biopsies were done. The patient in the first case was a 58-year-old woman and the patient in the second case was a 54-year-old woman. Both patients were admitted to our hospital because of dry coughing and exertional dyspnea. Chest X-ray films and CT scans showed interstitial shadows in both cases and multiple bullae in the first case. Pulmonary-function tests showed decreased diffusing capacity, and examination of bronchoalveolar lavage fluid revealed increased percentages of lymphocytes. Open-lung biopsy specimens showed thickening of the alveolar septa and interstitial mononuclear cell infiltration, composed predominantly of lymphocytes, with lymphoid follicles in both cases, and peribronchiolar mononuclear cell infiltration in the first case. Therefore, the histopathological diagnosis was cellular interstitial pneumonia with lymphoid follicles. Both patients were treated with oral corticosteroids. Symptoms were relieved and laboratory findings improved.

Biopsy↗

Fatal rhabdomyolysis during mountaineering.

We treated two rare cases of acute rhabdomyolysis induced by heat stroke encountered during mountaineering. The clinical findings were complicated by severe acute renal failure and disseminated intravascular coagulation (DIC), respectively. Though heat-related disorders occur frequently in mountain medicine in summer, severe and fatal rhabdomyolysis due to heat stroke is rare. It was also noteworthy that both patients had received treatment with antipsychotic drugs including phenothiazine. Even in a moderate exercise activity such as mountaineering, the possibility of rhabdomyolysis should be considered for all cases of heat stroke, especially those with a history of antipsychotic neuroleptics.

Fatal Outcome↗

[Distance walked in 10 minutes, pulmonary function, and pulmonary hemodynamics during exercise, in patients with pulmonary emphysema].

We examined relationships among the distance walked in 10 minutes (10 MD), pulmonary function, and pulmonary hemodynamics during exercise on a bicycle ergometer, in patients with chronic pulmonary emphysema who had dyspnea of grade III to IV on the Hugh-Jones scale. The 10 MD did not correlate significantly with desaturation during the 10-minute walk, but it did correlate significantly with the percent of predicted maximum voluntary ventilation, and it correlated negatively with airway resistance. These findings indicate that ventilatory impairment is an important factor limiting 10 MD in these patients. Also 10 MD correlated significantly and positively with %DLco; and it correlated negatively with the index of pulmonary vascular resistance and with the ratio of the change in pulmonary arterial pressure to the change in cardiac index during exercise. (delta Ppa/delta CI). These findings indicate that impairment of pulmonary circulation may also limit the 10 MD and exercise tolerance in patients with chronic pulmonary emphysema.

Aged↗

[Analysis of cells and proteins in bronchoalveolar lavage fluid].

We studied cells and proteins in bronchoalveolar lavage fluid examined at the First Department of Internal Medicine of Shinshu University Hospital between 1990 and 1994. The samples came from 21 healthy subjects and from 216 patients with various diseases. Lymphocyte counts were abnormally high in patients with bronchiolitis obliterans organizing pneumonia. Sjögren's syndrome, sarcoidosis and hypersensitivity pneumonitis. Neutrophil counts were very high in the patients with diffuse panbronchiolitis and in those with high-altitude pulmonary edema, and eosinophil counts were high in those with eosinophilic pneumonia. The CD4:CD8 ratio was significantly higher in the patients with stage I sarcoidosis than in the healthy subjects. The total protein concentration and the albumin concentration were significantly higher in the patients with eosinophilic pneumonia and in those with high-altitude pulmonary edema than in the healthy subjects, and these findings suggest that in those two conditions the permeability of the pulmonary microvasculature was abnormally high.

Adolescent↗

[Pulmonary malignant fibrous histiocytoma presenting as hemothorax].

A 39-year-old woman, who suffered from a sudden episode of severe left-sided back pain, was admitted to our hospital because of hemothorax. Chest CT scans revealed a mass extending from the left hilum to the posterior thoracic wall. The mass occluded the left pulmonary artery at the left main bronchus. Examination of a frozen section of a specimen obtained during a thoracotomy showed a sarcomatous tumor. A left pneumonectomy was then performed. Microscopic examination of a specimen revealed that the tumor was composed of spindle cells with cellular atypia and mitosis forming fascicles and storiform arrays. Malignant fibrous histiocytoma (storiform-pleomorphic pattern) was diagnosed. Chemotherapy was carried out six times during the year after surgery. No recurrence of the tumor has been seen during 20 months of follow-up.

Adult↗

[Two patients with idiopathic pulmonary fibrosis and monoclonal gammopathy].

A 67-year-old man and a 70-year-old man were admitted to our hospital because of dyspnea and dry coughing. Chest X-ray films showed bilateral reticulonodular shadows in the middle and lower lung fields. Specimens were obtained by open lung biopsies and the findings were compatible with those of usual interstitial pneumonia. Immunoelectrophoresis revealed monoclonal gammopathy in both patients. The levels of interleukin 6 in bronchoalveolar lavage fluid were high. In these two patients, idiopathic pulmonary fibrosis was associated with multiple myeloma and monoclonal gammopathy, and the levels of interleukin-6 in bronchoalveolar lavage fluid were high. These findings may help to elucidate the pathogenesis and development of idiopathic pulmonary fibrosis.

Aged↗

Staging of cardiac rejection by simultaneous administration of 123I-antimyosin and 111In-anti MHC class II antibodies.

Noninvasive diagnosis of cardiac rejection before the advent of myocyte necrosis is important in clinical management of cardiac transplantation. Mice with abdominal heart transplants were studied to determine whether a dual scintigraphy using antimyosin and anti-major histocompatibility complex (MHC) class II antigen monoclonal antibody (mAb) labeled with different isotopes allows to detect early rejection just before myocyte necrosis. Allografts from BALB/c donors were transplanted into C3H/He recipients. Mice were intravenously injected with 100 microCi each of 123I labeled antimyosin and 111In labeled anti-MHC class II mAbs and were sacrificed for gamma counting from 2 to 9 days after transplantation. Localization of two different isotopes was compared with histological degree of acute rejection. Uptake of 111In labeled anti-MHC class II mAb increased from the fourth day after transplantation, however, that of 123I labeled antimyosin mAb was shown only 9 days after transplantation. Induction of MHC class II antigen develops preceding the development of myocyte necrosis, and this difference in time course can be identified by the dual scintigraphy. Thus, dual scintigraphy using anti-myosin and anti-MHC class II mAbs is potentially useful in staging of cardiac rejection.

Animals↗

A 13-Mer peptide of a brain injury-derived protein supports neuronal survival and rescues neurons from injury caused by glutamate.

Neuronal survival is mediated by several kinds of proteins. Among these, neurotrophic factors play important roles in the nervous system by supporting neuronal activity and survival. It has been suggested recently that certain factors promote neuronal survival in the case of brain injury. To examine this possibility, we purified a novel neurotrophic factor from Gelfoam that was implanted at the site of injury caused in neonatal rats. During amino acid sequence analysis, we found that a fragmental peptide of this neurotrophic protein consisting of 13 amino acids showed neurotrophic activity. This 13-mer peptide promoted survival of septal cholinergic and mesencephalic dopaminergic neurons in culture and rescued hippocampal neurons from injury caused by glutamate in culture. This peptide rescued neurons from cell death caused by glutamate, even when added 4.5 h after glutamate exposure.

Amino Acid Sequence↗