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Biomedical subjects

N Ikuta

Publications and source records attributed to N Ikuta.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Outcomes of noninvasive positive-pressure ventilation in patients with acute hypercapnia complicating chronic respiratory failure].

We used noninvasive positive-pressure ventilation to treat hypercapnea due to acute exacerbations of chronic respiratory failure (21 episodes in 19 patients; COPD, 4; pulmonary tuberculosis sequelae, 4; silicosis, 3; silicotuberculosis, 3; bronchiectasis, 3; others, 2). All patients had acute onsets of severe hypercapnea (PaCO2 > 45 Torr), acute decreases in pH (< 7.35), and tachypnea, paradoxical breathing or both. During the first 2 to 4 hours of bi-level positive airway pressure, PaCO2 decreased from 72 to 61 Torr (p < 0.0005), pH increased from 7.26 to 7.31 (p < 0.001), and respiratory rate decreased from 30 to 25 breaths/min (p < 0.005). In three cases leakage of air through the mouth prevented improvement in the patients' conditions, but in two of those a face mask was then used successfully. In 17 of the 21 episodes (81%) gas exchange improved and intubation was not necessary. In those 17, the mean duration of noninvasive positive-pressure ventilation was 6.3 days. We conclude that noninvasive positive-pressure ventilation can improve gas exchange in patients with acute hypercapnea complicating chronic respiratory failure.

Acute Disease↗
PubMed1996

Sustained high levels of circulatory interleukin-8 are associated with a poor outcome in patients with adult respiratory distress syndrome.

Neutrophils are reported to be a major factor in the pathogenesis of the adult respiratory distress syndrome (ARDS). We measured serial levels of circulatory interleukin (IL)-8 and neutrophil elastase in 16 patients with ARDS at the onset, on day 3 and on day 7 and studied the relationship of these levels to the clinical course. Circulatory IL-8 levels of all the patients at the onset were significantly elevated compared with controls, mean +/- SE, 30.0 +/- 6.7 pg/ml and 3.3 +/- 0.3 pg/ ml, respectively. There was a significant correlation between IL-8 and neutrophil elastase levels at the onset (r = 0.65, p < 0.01). In nonsurvivors circulatory IL-8 levels were significantly higher than those of survivors throughout the study. There were significant differences in oxygenation, as reflected by PaO2/FIO2 ratios, between survivors and nonsurvivors at day 7, mean +/- SE, 208.5 +/- 21.9 and 113.5 +/- 9.6, respectively. In conclusion, we have shown that the level of circulatory IL-8 is elevated in patients with ARDS, and sustained high levels of circulatory IL-8 might be correlated with a poor outcome.

Adult↗
PubMed1996

[Rapidly progressing BOOP in a patient with positive anti-Jo-1 antibody: response to corticosteroid pulse and immunosuppressant therapy].

A 61-year-old woman was admitted to our hospital with a two week history of knee-joint pain, dry coughing and dyspnea on exertion. A chest roentgenogram revealed bilateral patchy and infiltrative shadows. Laboratory examination revealed high CK and aldolase levels. Although myositic symptoms were absent, the respiratory symptoms rapidly worsened and respiratory failure developed. An open-lung biopsy and a muscle biopsy were done. The open-lung biopsy specimen showed bronchiolitis obliterans organizing pneumonia (BOOP), but the muscle biopsy specimen revealed non-specific findings. After 4 weeks of intravenous intermittent high-dose corticosteroid therapy, 50mg of cyclophosphamide was given daily, along with 20mg of prednisolone on alternate days. There were marked clinical, physiological and roentgenographic improvements. A test for anti-Jo-1 antibody was positive, which suggested that this patients had pulmonary manifestations of polymyositis/dermatomyositis. Although BOOP can have an indolent course and a good prognosis, it may rapidly worsen and respiratory failure may develop, in which case it should be treated aggressively with a combination of intravenous high-dose corticosteroids and immunosuppressants.

Antibodies, Antinuclear↗
PubMed1996

[Effect of long-term treatment with an inhaled corticosteroid on bronchial hyper-responsiveness and clinical asthma in asthmatic subjects].

We studied retrospectively the effect of long-term treatment with an inhaled corticosteroid on bronchial hyperresponsiveness (BHR) and clinical asthma in moderate-severe asthmatic subjects. Fifty-eight patients who had used beclomethasone dipropionate (BDP) over one year, were enrolled in this study. BHR was measured before and after treatment with BDP by the methods recommended by Japanese Society of Allergology. Moreover we examined the clinical factors and the frequency of acute exacerbations. The results as follows: 1) The mean age was 48.8 years and the mean asthma history was 9.2 years. The mean dose and mean time of BDP administration was 801 micrograms/day and 28.1 months, respectively. 2) Patients during BDP treatment over one year showed about 6-fold mean improvements in BHR, but there were many patients who showed no improvements in BHR. 3) We retrospectively divided all the patients into two groups. Namely, the improved group (n = 25) showed more than 4 fold improvement in BHR and unchanged group (n = 33), less than 4-fold. But there were no significant differences in clinical characteristics and %FEV1 during treatment with BDP. 4) The unchanged group had more near fatal episodes in the past than the improved group. 5) There was significant decrease in acute exacerbation during treatment with BDP, but the unchanged group had more acute exacerbations than the improved group during treatment with BDP. These results indicates that there are many patients who had no improvement on BHR with long term BDP treatment and they have more acute exacerbations due to various stimuli. In conclusion, asthma is recognized chronic inflammatory disease and inhaled corticosteroid therapy has been recommended as the first line therapy. We must further study the clinical problems and underlying mechanisms concerning about treatment with an inhaled corticosteroid.

Anti-Asthmatic Agents↗
PubMed1996

Hepatitis C virus genotypes in Southern Brazil.

The prevalence of hepatitis C virus (HCV) genotypes in Southern Brazil was studied in the plasma of 100 HCV-RNA-positive patients attended in Porto Alegre, South of Brazil. Reverse transcription-polymerase chain reaction (RT-PCR) products from the 5' noncoding region were double digested with RsaI-HaeIII and BstNI-HinfI and analyzed by restriction fragment length polymorphism (RFLP). Three genotypes (1, 2 and 3) were demonstrable, the most prevalent being HCV type 1 (55 of 100 patients, 55%), followed by HCV type 3 (37 of 100 patients, 37%) and HCV type 2 (8 of 100 patients, 8%). There was an unusual high prevalence of genotype 3, in contrast to the majority of published data from the Southeast region.

Brazil↗
PubMed1995

Separation of membrane proteins solubilized with a nondenaturing detergent and a high salt concentration by hydroxyapatite high-performance liquid chromatography.

Ceramic hydroxyapatite high-performance liquid chromatography with a solvent containing high concentrations of salts was used for the separation of membrane proteins solubilized under nondenaturing and high salt conditions. The chromatographic conditions were optimized using sodium cholate as the detergent. By this method, most membrane proteins, prepared from rat liver rough microsomes, were effectively resolved from each other with a protein recovery of more than 90%. The method also allowed the single-step purification of the ribosome-binding protein, p34, from a microsomal membrane protein fraction. The good resolution with this method should be applicable to the isolation and characterization of a variety of membrane proteins on the analytical and semipreparative scales. With only the substitution of sodium cholate with other nondenaturing detergents, this method may also be applicable to the purification of membrane proteins requiring such nondenaturing detergents with retention of their biological activities.

Cholic Acid↗
PubMed1995

A rapidly progressive case of interstitial pneumonia.

We treated a 51-year-old woman who had rapidly progressive respiratory distress with an interstitial shadow on chest roentgenogram. Pathologically, open lung biopsy specimens showed an acutely changed lesion such as interstitial inflammatory thickening, polypoid intraluminal organizing exudates, and also honeycombing which was not recognized on chest computed tomogram. These findings were considered unconformable to acute interstitial pneumonia (AIP), bronchiolitis obliterans organizing pneumonia (BOOP), and also usual interstitial pneumonia, although the clinical diagnosis was AIP or BOOP. We diagnosed a rapidly progressive interstitial pneumonia showing an acute lung injury pattern like AIP and BOOP. She showed significant recovery with corticosteroid and cyclophosphamide.

Acute Disease↗
PubMed1995

Laser high performance liquid chromatography determination of prostaglandins in pleural effusions.

We measured prostaglandins (PGs) in human pleural effusions of 43 patients with various diseases using microcolumn high performance liquid chromatography with a He/Cd laser induced fluorescence detection system. PGD2 was not detected in the transdate effusions. In contrast, PGD2 was detected in pleural exudates (malignant effusions: 0.22 +/- 0.07 nmol/ml, tuberculous effusions: 0.28 +/- 0.08 nmol/ml). PGE2 and 6-keto-PGF1 alpha concentrations in malignant effusions (1.62 +/- 0.17 nmol/ml, 14.40 +/- 1.33 nmol/ml, respectively) were significantly increased compared with tuberculous effusions (0.98 +/- 0.13 nmol/ml, 10.36 +/- 0.92 nmol/ml) and transdates (0.60 +/- 0.06 nmol/ml, 6.91 +/- 0.61 nmol/ml). On the contrary, there was no significant difference in PGF2 alpha concentrations between malignant effusions and tuberculous effusions. From these results, not only PGE2 but also PGD2 and PGI2 might be implicated in the pleural fluid accumulation.

Aged↗
PubMed1995

[Diagnosis of acute respiratory distress syndrome: analysis of bronchoalveolar lavage fluid].

To better understand the pathogenesis of acute respiratory distress syndrome (ARDS), we analyzed bronchoalveolar lavage fluid (BALF) from patients with ARDS (n = 89, survival rate = 56.2%), who were admitted to our intensive care units over the past 7 years. ARDS was diagnosed when the lung injury score proposed by Murray et al was greater than 2.5. The BALF had very high centrations of albumin, a marker of permeability edema, along with remarkably high neutrophil counts, percent neutrophils, neutrophil-elastase, and interleukin-8, markers of neutrophil-related lung injury. In addition, the level of IL-8 in BALF was higher in non-survivors than in survivors. Levels of thrombin-antithrombin complex fibrin degenerative product and soluble thrombomodulin (recently recognized as a natural anticoagulant combined with vascular endothelial cells) were very high in BALF from patients with ARDS. Moreover, the level of soluble thrombomodulin in BALF was higher in non-survivors than in survivors. There were significant relationships between these neutrophil-related markers and markers of abnormal coagulation. The results of the BALF analysis suggest that accumulation and activation of neutrophils can affect thrombomodulin on vascular endothelial cells, which can activate thrombin and cause the coagulopathy seen in ARDS.

Adult↗
PubMed1993

Demonstration of the phosphorylation-dependent interaction of tryptophan hydroxylase with the 14-3-3 protein.

The molecular mechanism of the phosphorylation-dependent activation of tryptophan hydroxylase is studied with respect to the role of the 14-3-3 protein. Reexamination of the system reconstituted with the purified TRH and the 14-3-3 protein showed that the level of the TRH activity correlated with the extent of the Ca2+/calmodulin- or the cAMP-dependent phosphorylation in TRH. The experiment confirmed the requirement of the 14-3-3 protein for the activation, but the 14-3-3 protein added into the assay mixture did not affect either the extent nor the specificity of the phosphorylation. However, the analysis of the assay mixture on a pteridine-based affinity column indicated the formation of a complex between TRH and the 14-3-3 protein, where the complex formation depended on the phosphorylation of TRH. The complex between the phosphorylated TRH and the 14-3-3 protein could also be detected by analysis of crude brainstem extract previously phosphorylated by endogeneous Ca2+/calmodulin-dependent protein kinase. The 14-3-3 protein, therefore, appears to be a phosphorylation-dependent TRH-binding protein whose interaction causes the activation of TRH.

14-3-3 Proteins↗
PubMed1993

Psychotic symptoms in depression and borderline personality disorder.

The authors investigated the prevalence of psychotic symptoms in depression and borderline personality disorder employing the Diagnostic Interview for Borderlines. Clear-cut delusions and hallucinations were rare among the borderlines. However, derealization and depersonalization symptoms were common and were found to be prevalent as among depressives. The prevalence of these symptoms among patients with both borderline personality disorder and depression was similar to that among patients with only borderline personality disorder or depression. The relationship between depression and borderline personality disorder and the significance of psychotic symptoms in these disorders is discussed.

Adolescent↗
PubMed1993

Object images of eating disorder patients.

The authors investigated images held by eating disorder patients toward selected stimulus words using the semantic differential method. The concept "object image" was introduced here to designate the images which any person has about the mother, the father, etc. A comparison was made between 22 eating disorder patients with concurrent borderline personality disorder, 20 patients without borderline pathology, and 48 controls. The eating disorder patients were found to have a "weaker" image of "motherliness" and "womanliness" compared to the control group. Another characteristic of eating disorder patients was their unfavorable image of children. The authors also studied the images held by fathers and mothers. In the families with borderline patients, the discrepancies between what we term "object images" held by fathers, mothers, and daughters were conspicuous. The importance of a tripartite (daughter-mother-father) relationship in the psychopathology of eating disorder is discussed.

Adolescent↗
PubMed1993

Relationship between clinical symptoms and EEG findings in borderline personality disorder.

Borderline personality disorder (BPD) was diagnosed in female patients (N = 41) between the ages of 18 and 30 using the Diagnostic Interview for Borderline Patients (DIB) and DSM-III. Comparing the EEG findings of BPD (N = 18) and non-BPD (N = 21) groups, there were no EEG findings characteristic of BPD. We also assessed the relationship between the EEG findings and DIB items. Positive spikes appeared in patients with high scores for Impulse Action Patterns, while wave and spike phantoms were observed in patients with high scores for Interpersonal Relations. Dividing the patients into BPD and non-BPD groups, a similar tendency to that observed from an analysis of all patients was observed in the non-BPD group, but no such tendency was observed in the BPD group. The results suggest that BPD patients include those in whom vulnerability of cerebral function plays an important role in the development of these two clinical symptoms as well as those in whom vulnerability of cerebral function plays almost no pathogenic role.

Adult↗
PubMed1993

[A case of drug induced pneumonitis caused by oral etoposide].

We report a case of drug induced pneumonitis caused by oral etoposide. A 63-year-old man was admitted to our hospital in August 1991 because of low grade fever and dyspnea. He underwent right upper lobectomy on Nov. 27th, 1990 for lung cancer (squamous cell carcinoma), and courses of adjuvant chemotherapy (CBDCA, IFX, etoposide) during the following admission period. He was discharged on Feb. 14th, 1991, and as an outpatient, oral etoposide (25 mg/day) was administered for about 7 months (6,125 mg in total). Chest X-ray film on admission showed reticulonodular shadows in bilateral lung fields, and computed tomography showed diffuse interstitial shadows. Blood gas analysis showed marked hypoxemia (PaO2 breathing room air was 48.4 Torr). Transbronchial lung biopsy revealed edema of the alveolar walls and marked proliferation of type II alveolar epithelial cells, suggesting cytotoxic reaction. After termination of etoposide administration and following steroid pulse therapy, both clinical symptoms and hypoxemia were ameliorated. To our knowledge, this is the first report of etoposide-induced pneumonitis.

Administration, Oral↗
PubMed1992

Implication of oxygen radicals on airway hyperresponsiveness after ovalbumin challenge in guinea pigs.

We elucidated the implication of oxygen radicals on airway hyperresponsiveness after ovalbumin (OA) challenge in guinea pigs. Ten days OA exposure increased airway responsiveness, i.e., a significant decrease in log [acetylcholine (Ach) PC200] (2.445 +/- 0.227) was observed compared with the control group (3.398 +/- 0.269). After OA exposure, the number of beta-adrenoceptors decreased by 38%, and adenylate cyclase activity decreased by 36% (isoproterenol stimulated) and 28% (basal). Significant increases in xanthine oxidase activities in lung tissue, bronchoalveolar lavage fluid (BALF), and serum were observed after the tenth OA exposure (49.1 +/- 11.7 mU/g tissue, 12.6 +/- 3.16 mU/ml, and 11.5 +/- 2.66 mU/ml, respectively) compared with those in the control group (7.35 +/- 6.48 mU/g tissue, 2.85 +/- 1.17 mU/ml, and 3.51 +/- 1.15 mU/ml, respectively). Administration of long-acting superoxide dismutase (SOD) (5,000 U/kg twice a day intraperitoneally) or gamma-glutamylcysteine ethyl ester (gamma-GCE) (10 mg/kg, twice a day, intraperitoneally), a prodrug of glutathione, maintained log [Ach PC200] (3.248 +/- 0.415 and 3.298 +/- 0.246, respectively) in spite of 10 days OA exposure. Decreases in the number of beta-adrenoceptors and adenylate cyclase activity were prevented by long-acting SOD or gamma-GCE. In contrast, long-acting SOD or gamma-GCE inhibited significantly, but not completely, the elevation of xanthine oxidase activities. These results support suggestions that oxygen radicals might be involved in the underlying mechanism of airway hyperresponsiveness after OA challenge in guinea pigs.

Adenylyl Cyclases↗
PubMed1992

[A case of bronchiolitis obliterans organizing pneumonia in a patient with rheumatoid arthritis who responded to corticosteroid and immunosupressant therapy].

A 56-year-old man with rheumatoid arthritis was admitted to our hospital with dyspnea on exertion, fever and right chest pain. Chest X-ray showed bilateral, predominantly lower interstitial shadows and right pleural effusion. Open lung biopsy specimen showed bronchiolitis obliterans organizing pneumonia (BOOP) with prominent alveolitis, and corticosteroid therapy was introduced. Because the patient showed little response to corticosteroids, an immunosupressant (cyclophosphamide) was added. There was marked clinical, physiological and roentgenographic improvement in response to combined therapy. The therapeutic response of some BOOP patients seems to vary according to its pathogenesis and pathological findings, and these should be taken into consideration in the selection of therapeutic strategies.

Adrenal Cortex Hormones↗
PubMed1991

[Stevens-Johnson syndrome associated with Mycoplasma pneumoniae infection in an adult].

A case of Stevens-Johnson syndrome caused by Mycoplasma pneumoniae in a 34-year-old woman is presented. At first, she was admitted for treatment of pneumonia with cefuzonam. She was discharged in good health twelve days after admission. However, three days after discharge, she was admitted again with fever, erythematous lesions, oral ulcerations and exudative conjunctivitis. Because M. pneumoniae infection was confirmed by the presence of an elevated IHA titer, a clinical diagnosis of Stevens-Johnson syndrome associated with M. pneumoniae infection was made. Also, Mycoplasma CF antigen-lymphocyte stimulation test (LST) gave positive results, while the cefuzonam-LST was negative. Treatment with methylprednisolone and minocycline was initiated. Resolution of lesion was evident only after thirty days and then steroid therapy was discontinued. This association has rarely been reported in adults. M. pneumoniae infection should be considered in cases of Stevens-Johnson syndrome in adults with pneumonia.

Adult↗