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N Okimoto

Publications and source records attributed to N Okimoto.

At least 19 recordsLinked to original sources

Effect of monoclonal anti-human gp130 antibody (GPX7) on bone turnover in normal and ovariectomized rats.

We examined the effects of a monoclonal antihuman gp130 antibody (GPX7), which is known to inhibit interleukin-6 (IL-6) and leukemia inhibitory factor-mediated responses in human cells on the bone metabolism in normal and ovariectomized (OVX), 7-month-old, Wistar rats for 8 weeks. After confirming the cross-reactivity of the antibody in suppressing the IL-6-mediated proliferation of rat liver cells, GPX7 was injected once a week at doses of 1 (low dose) or 4 (high dose) mg/kg body weight (BW). In the lumbar body, bone mineral density values and the trabecular bone volume (BV/TV) were maintained in the GPX7 groups. The values of the trabecular osteoclast surface and number in the GPX7 high-dose group were significantly smaller than those in the OVX controls. The double-labeled surface and bone formation rates in the GPX7 high-dose group were significantly increased. In the proximal tibia, however, the bone mineral content and BV/ TV values in the GPX7 groups were smaller, but the trabecular thickness value in the GPX7 high-dose group was larger than in the OVX control. The single-labeled surface in the GPX7 high-dose group was significantly larger than that in the OVX control rats. Though the parameter values of trabecular osteoclasts were apparently smaller, the differences were not significant. 17-beta estradiol (0.125 mg/kg BW a week) administration prevented the bone loss by reducing the parameters of bone formation and resorption in both the lumbar and the proximal tibia. The antibody administration to the normal rats did not cause any significant changes in the parameters of bone mass and turnover. These data demonstrate that while GPX7 modulates the bone turnover after ovariectomy in rats, it does not compensate for the action of estrogen after ovariectomy in rats.

Alkaline Phosphatase

Effects of a weekly injection of human parathyroid hormone (1-34) and withdrawal on bone mass, strength, and turnover in mature ovariectomized rats.

One hundred fifteen Wistar rats, 7 months of age, were ovariectomized (ovx) or sham-operated to evaluate the effects of a weekly injection of human parathyroid hormone (hPTH) and withdrawal on the bone mass, strength, and turnover in mature ovariectomized rats. At 3 months, ovx rats were given a weekly injection of hPTH(1-34) at the respective doses of 0 (vehicle), 10, and 90 microg/kg body weight (BW) for 3 months. Then, hPTH-treated rats were divided into two groups each: continuously treated groups, and the groups treated with vehicle only for another 3 months. Weekly hPTH injections at doses of 10 or 90 microg/kg BW maintained the lumbar BMD values and increased the values of the femoral cortical bone, increasing the bone formation rates in the trabecular, endocortical, and periosteal envelopes. Trabecular osteoclasts were increased in the 90 microg/kg dose group. Trabecular bone surface relative to the volume was decreased by hPTH. The compressive load of the lumbar bone and the bending moment of the midfemur were increased. The lumbar compressive load values, corrected for BMD and volume, and the moment of inertia of the midfemur were also increased. The intracortical porosity values were not increased by the treatment. After withdrawal of hPTH treatment, the BMD values in both the lumbar and the midfemur were reduced to ovx control levels. The bone mass stimulated by the 90 microg/kg dose was reduced faster than that by the 10 microg/kg dose. However, the parameters of bone strength were still larger than those of the ovx controls after cessation of the hPTH treatment. Thus, a weekly hPTH injection effectively stimulated the bone formation in both the trabecular and cortical bone, leading to positive effects on mass and structure of the bone. These data suggest the possibility of benefits of both a lower frequency of hPTH injections as well as high-frequency injections for human osteoporotics.

Absorptiometry, Photon

Responses of trabecular and cortical bone turnover and bone mass and strength to bisphosphonate YH529 in ovariohysterectomized beagles with calcium restriction.

Thirty-six beagles, 18 months of age, underwent ovariohysterectomy (OHX) or a sham operation. Sham-operated animals were given a diet with standard calcium (1.4%) (group 1, n = 6) or a restricted calcium diet (0.14%) (group 2, n = 6). The OHX animals were given the restricted calcium diet and YH529 orally with respective daily doses of 0, 0.02, 0.1, and 0.5 mg/kg of body weight (groups 3-6, n = 6 each) for 12 months. At the end of this period, the lumbar bone mineral densities (BMDs) in groups 2 and 3 and the load values for group 3 were significantly smaller than those for group 1. The midfemur BMD did not differ among the groups. The urinary deoxypyridinoline (U-Dpy) and bone formation rates (BFR/BS, BFR/BV) in groups 2 and 3 and the osteonal BFR/BS and trabecular osteoclast number (Oc.N/BS) in group 3 were significantly larger than the respective values for group 1. However, these parameters did not significantly differ between groups 2 and 3. The serum osteocalcin (OC) level, wall thickness (W.Th), and mineral apposition rate values for group 3 were significantly larger than those for group 2. In group 2, the trabecular activation frequency (Ac.F) increased by 3.11 times, and the percent values of the number of labeled osteons (L-Ot.N/T-Ot.N, %) in the tibia by 3.28 times over those for group 1. In group 3, the Ac.F increased by 3.20 times and the number of labeled osteons by 3.77 times over those for group 1. In groups 4-6, the U-Dpy and Oc.N/BS values were smaller, but their OC levels did not significantly differ from the level for group 3. The lumbar BMD, the load, and W.Th were dose-dependently significantly larger than those for group 3. The Ac.F values were significantly smaller, and the respective value in groups 4-6 was 67.9, 25.5, and 10.2% of that in group 3. The BMDs of the midfemur in groups 4-6 were significantly larger than those in group 3, but the ultimate load values did not significantly differ. The L-Ot.N/T-Ot.N values were also significantly smaller, and the respective value in groups 4-6 was 82.0, 48.5, and 55.2% of that in group 3. The tibial endocortical and periosteal BFR/BSs did not differ significantly. These data demonstrate that the effects of OHX on bone mass and turnover were small in the beagles fed a restricted calcium diet. YH529 maintained the mass and strength of the lumbar bone by reducing the bone resorption. The cortical bone appeared to be less sensitive to the agent than the trabecular bone in this animal model.

Administration, Oral

[Home oxygen therapy in the elderly].

Between 1984 and September 1995, we prescribed home oxygen therapy for 155 patients (96 men and 59 women), mean age 68.6 years) with chronic respiratory failure. Here we describe the underlying diseases, laboratory findings (arterial blood gas analysis and pulmonary-function tests), and outcomes. We also report differences between those who were of least 70 years old (n = 82) and those less than 70 years old (n = 73). The underlying diseases were chronic obstructive pulmonary disease in 55 patients, lung cancer in 33, old pulmonary tuberculosis in 29, and pulmonary fibrosis in 27. Chronic obstructive pulmonary disease, especially pulmonary emphysema, was the most frequently encountered underlying disease in the older patients, whereas pulmonary fibrosis and lung cancer were most common in the younger patients. The duration of observation ranged from less than 1 month to 10 years. At the time of this study 82 patients had died, 31 were still being treated as outpatients at our hospital, 32 had transferred to other hospitals, and the status of 10 patients was unknown. The older and younger patients did not differ with regard to arterial blood gases, pulmonary function at the time home oxygen therapy began, or outcome: We believe that home oxygen therapy was very beneficial in these patients with chronic respiratory failure, because their quality of life improved after the start of this therapy.

Aged

[Clinical and laboratory findings associated with the severity of community-acquired pneumonia].

To clarify the clinical features of severe community-acquired pneumonia, we retrospectively studied 121 patients treated at our hospital. We divided the patients into three groups, based on the severity, of their disease. Patients were put in the "mild" group (n = 56) if they recovered after treatment with antimicrobial agents only, they were put in the "moderate" group (n = 34) if the required oxygen therapy and recovered, and they were put in the "severe" group (n = 31) if they required mechanical ventilation. Age and underlying disease were recorded, as well as signs, symptoms, and laboratory data obtained during the first 24 hours after admission. The data indicated that the following nine findings were associated with the severity of disease: age of at least 65 years, an underlying disease of (31) the respiratory or central nervous system, dyspnea, a pulse rate of at least 90 beats per minute, a respiratory rate of at least 25 breaths per minute, an albumin concentration no greater than 3.5 g/dl, a blood urea nitrogen level of at least 20 mg/dl, a PaO2 no greater than 60 mmHg or an SaO2 no greater than 90%, and a high score on a scale of the extent of roentgenographic evidence of pulmonary infiltrates. Patients in whom these are found be managed carefully.

Adult

[A case of Plasmodium ovale malaria with thrombocytopenia and an abnormality grade in FDP concentration despite the use of chloroquine as a malaria prophylaxis].

A 45-year-old Japanese male, who had been to the Central African Republic, was admitted to our hospital because of high fever with chills on July 29, 1994. He used chloroquine as a malaria prophylaxis during his stay and for 6 weeks after his return to Japan. On admission, Plasmodium ovale was detected in his blood smears and in the DNA analysis. He was treated successfully with chloroquine (1500 mg over 3 day period) and primaquine (15 mg/day for 14 days beginning day 4). Disappearance of malarial parasites in the peripheral blood smear occurred on the third day and his temperature returned to normal on the 4th day. Interestingly, he had thrombocytopenia and an abnormal grade in fibrin degradation products (FDP) concentration. This led to the suspicion of disseminated intravascular coagulation (DIC). This report indicates the importance of thrombocytopenia which may develop into DIC even though P. ovale malaria infection rarely becomes severe. This is the second report of a P. ovale malaria case in the Central African Republic.

Animals

[A case of Aspergillus niger pneumonia cured with an early diagnosis].

We have experienced a case with A. niger aspergilloma who developed Aspergillus pneumonia after bacterial pulmonary infection. Examinations of sputum cytology and detection of serum Aspergillus antigen were useful for an early diagnosis of his condition. Early and intensive antifungal chemotherapy mainly with intravenous amphotericin B brought about his complete remission.

Amphotericin B

[A case of pulmonary alveolar proteinosis with high levels of tumor markers].

We report a case of pulmonary alveolar proteinosis (PAP) in which the serum levels of CEA, CA15-3, and TPA, as well as the whole lung lavage fluid levels of CEA, CA19-9, CA125, CA15-3, CA50, SLX, SCC, and TPA were high. The patient was a 39-year-old man who presented with exertional dyspnea, and nonsegmental bilateral reticular infiltration shadows in the middle and lower lung fields on the chest radiograph. A diagnosis of proteinosis was confirmed by histopathology of the transbronchial lung biopsy (TBLB) specimen, biochemical analysis of the phospholipids, and an electron microscopic study of lavage fluid. Whole lung lavages alleviated his symptoms, effaced the shadows on the chest radiographs and brought the blood gas values closer to normal. An immunohistochemical study of TBLB specimens showed that CEA, CA153, and SLX were positively stained in the alveolar epithelia. With repeated lavage, tumor markers (CEA, CA15-3, TPA) in the fluid decreased. These results suggest that the alveolar epithelia indeed produced these tumor marker molecules. In PAP, it is well recognized that CEA may be high in at least one of the following: serum, bronchoalveolar lavage fluid, and whole lung lavage fluid. To date, however, the site of production of such tumor markers had not been clearly demonstrated to be in the lung tissue. This case is interesting because there are few reports of PAP with high levels of tumor markers in the serum and whole lung lavage fluid, and because the tumor markers found in abnormally high amounts in this patient were produced by alveolar epithelia.

Adult

[Two cases of invasive pulmonary aspergillosis in non-immunocompromised hosts].

Invasive pulmonary aspergillosis generally occurs in immunocompromised hosts such as patients with leukemia, and other malignancies, who are receiving anti-cancer chemotherapy. In this report, two non-immunocompromised patients who developed invasive pulmonary aspergillosis are presented. Case 1: A 63-year-old man complained of productive cough and fever. He received antibiotic therapy from his personal physician. This symptoms did not respond, however, and dyspnea developed. He was then transferred to our hospital, about one month after the onset. The chest X-ray showed a meniscus shadow suggesting an aspergilloma in the right upper lung field and an infiltrative shadow in the remaining right lung field. Case 2: A 78-year-old man was admitted because of dyspnea, productive cough and appetite loss over the previous three months. The chest X-ray showed a meniscus shadow in the left upper field, an infiltrative shadow in the left lower field and a right pleural effusion sign was also observed. Both cases were diagnosed as having aspergillosis, early in their illness, by the detection of aspergillus antigen in their sera and histopathological and cultural studies of specimens obtained by TBLB. Both improved with intravenous amphotericin B (30 mg/day) and intravenous ulinastatin (200000 IU/day) administration. On the examinations conducted during hospitalization, there was no evidence of any immunosuppressive diseases or immunoincompetent conditions such as leukemia, and other malignancies human immunodeficiency virus infection, diabetes or alcoholism.

Aged

[Studies on risk factors influencing delayed resolution of pneumonia].

Among 61 patients admitted to our hospital because of bacterial pneumonia during the last six years, we investigated several risk factors influencing delayed resolution of pneumonia shadows, such as age, extent of the lesion, period of fever and sputum production after antibiotic therapy, WBC, CRP and PaO2 values on admission, the period of increased values of WBC and CRP, the presence or absence of etiological pathogens, the period from the appearance of symptoms to admission, and the period of drug therapy. In our series, the period from appearance of symptoms to admission (r = 0.62) and that of increased WBC (r = 0.35) significantly correlated with the period of pneumonia shadows to the time of their resolution. Similar results were obtained from the multiple variate analysis of various factors. These results suggest that the duration period (nontherapy period) of inflammation closely associated with leukocytosis plays a crucial role in the delayed resolution of pneumonia shadows.

Adult

Atelectatic lung escaping radiation pneumonitis.

An 80-year-old man was admitted to our division because of hemosputum, cough, and chest pain for three months. A chest roentgenogram, chest CT scanning, and bronchoscopic examinations revealed adenocarcinoma of the lung with atelectasis of the right upper lobe. The patient developed radiation pneumonitis after receiving radiation therapy (5,100 cGy) for lung cancer. At the same time, the right upper lobe atelectasis improved and movement of infiltrates consistent with radiation pneumonitis to the middle lung fields occurred. A chest roentgenogram taken when the atelectasis had improved revealed the absence of pneumonitis shadows in the right upper lobe, suggesting that the atelectatic lung escaped radiation pneumonitis.

Aged

[A case of endobronchial fibroma associated with recurrent pneumonia].

We present a case of endobronchial fibroma in a 59-year-old man admitted for repeated pneumonia, successfully treated by endoscopic Nd-YAG laser. His chest X-ray showed an infiltrative shadow in the right lower lung field and a mass shadow within the truncus intermedius. Bronchoscopy revealed a polypoid mass with lobulated whitish surface, obstructing 90% of the lumen. A biopsy taken from the tumor was suggestive of fibroma histologically. Two previous case reports stated that endobronchial fibroma readily detaches from the bronchial wall during removal. The tumor was successfully removed without dropping any tumor fragment to obstruct the distal bronchus by means of biopsy forceps manually attached to an endoscope with endoscopic Nd-YAG laser. The resected tumor was mainly composed of collagen fibers with scanty spindle-shaped fibroblastic cells, which was considered consistent with endobronchial fibroma. Endobronchial fibroma is a rare benign lung tumor, and only seven cases have been reported in the Japanese literature. There was no recurrence at three years and nine months.

Bronchial Neoplasms

[A comparative study between cefpirome (CPR) and ceftazidime (CAZ) in respiratory tract infections].

Efficacy and safety of a new injectable cephem antibiotic, cefpirome sulfate (hereafter, CPR), against respiratory tract infections were examined and compared with those of a control drug, ceftazidime (hereafter, CAZ). As a rule, CPR 0.5 g twice a day, 1.0 g twice a day, or CAZ 1.0 g twice a day (hereafter CPR 0.5 g group, CPR 1.0 g group, and CAZ group) was administered for 14 days and the following results were obtained. 1. The total number of cases was 470 (155 cases in the CPR 0.5 g group, 160 cases in the CPR 1.0 g group, and 155 cases in the CAZ group). Among them 390 cases were subjected to analyses of clinical efficacy by the efficacy evaluation committee (131 cases in the CPR 0.5 g group, 131 cases in the CPR 1.0 g group and 128 cases in the CAZ group). 2. Efficacy rates determined by the efficacy evaluation committee were 82.4% (108/131) for the CPR 0.5 g group, 81.7% (107/131) for the CPR 1.0 g group, and 83.6% (107/128) for the CAZ group. Efficacy rates determined by the physician in charge were 82.0% (105/128) for the CPR 0.5 g group, 80.5% (99/123) for the CPR 1.0 g group, and 88.5% (108/122) for the CAZ group. No statistically significant difference was observed among the 3 groups. In evaluation of equivalency, clinical efficacy for the CPR 0.5 g group and the CPR 1.0 g group determined by the clinical efficacy evaluation committee was proved to be statistically equivalent to that for the CAZ group. 3. In patients with pneumonia, efficacy rates determined by the efficacy evaluation committee were 87.1% (61/70) for the CPR 0.5 g group, 80.7% (71/88) for the CPR 1.0 g group, and 78.9% (56/71) for the CAZ group. Efficacy rates determined by the physician in charge were 85.3% (58/68) for the CPR 0.5 g group, 80.7% (67/83) for the CPR 1.0 g group, and 86.2% (56/65) for the CAZ group and no statistically significant difference was observed among the 3 groups. In patients with chronic respiratory tract infection, efficacy rates determined by the efficacy evaluation committee were 77.0% (47/61) for the CPR 0.5 g group, 83.7% (36/43) for the CPR 1.0 g group, and 89.5% (51/57) for the CAZ group. Efficacy rates determined by the physician in charge were 78.3% (47/60) for the CPR 0.5 g group, 80.0% (32/40) for the CPR 1.0 g group, and 91.2% (52/57) for the CAZ group. No statistically significant difference was observed among the 3 groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent

[An optimum dose-finding study of HR810 (CPR) in chronic respiratory tract infections].

In order to determine the optimal dose of cefpirome sulfate (HR810, CPR) against respiratory tract infections (RTI), an optimal dose-finding study was conducted on cases of chronic RTI, and the clinical properties of the drug were compared with those of ceftazidime (CAZ). Inpatients with chronic RTI were randomly assigned to 3 groups: an HR 0.5 g group, receiving 0.5 g X 2/day of CPR an HR 1.0 g group, receiving 1.0 X 2/day of CPR and a CAZ group, receiving 1.0 g X 2/day of CAZ. As a rule, the drugs were administered by intravenous drip infusion for 14 days, after which period clinical efficacy, bacteriological response, safety, and utility were investigated. Of the total 121 cases, 106 were subject to analysis of clinical efficacy, including 38 cases in the HR 0.5 g group, 32 in the HR 1.0 g group, and 36 in the CAZ group. Efficacy rates in the assessment by the committee were 84.2% for the HR 0.5 g group, 75.0% for the HR 1.0 g group, and 86.1% for the CAZ group, without any significant difference between the 3 groups. The bacterial elimination rates were 73.9%, 75.0% m and 88.5%, respectively, without any significant difference between the 3 groups. Associated reactions were noted in 2 of 36 cases in the HR 1.0 g group (eruption and diarrhea), but not in the other 2 groups. The incidence of abnormal clinical laboratory findings was 23.1% in the HR 0.5 g group, 22.2% in the HR 1.0 g group, and 22.5% in the CAZ group, without any significant difference between the 3 groups. Utility rates were 84.2% for the HR 0.5 g group, 74.2% for the HR 1.0 g group, and 86.1% for the CAZ group, without any significant difference between the 3 groups. The HR 0.5 g and 1.0 groups showed no difference in clinical efficacy, bacteriological response, safety, and utility against RTI, and the results of both groups were about equal to those of the CAZ group.

Adolescent

[Bronchial asthma associated with primary lung cancer--comparison of extrathoracic malignancies].

Regarding 249 bronchial asthma patients having been admitted to our division for the recent 9 years, clinical manifestations of 8 bronchial asthma with primary lung cancer (group A; squamous cell carcinoma--5 cases, adenocarcinoma--2 cases, small cell carcinoma--1 case; 3.2% of 249 cases) and 8 asthma patients with extrathoracic malignancy (group B; gastric cancer--3 cases, malignant lymphoma--2 cases, bladder cancer--1 case, laryngeal cancer--1 case, prostatic cancer--1 case) were investigated. In group A, the mean of asthmatic history was 19 years and all cases were associated with respiratory tract infections. Three of 8 patients, were mild type and other 5 were moderate type. In group B, the mean of asthmatic history was 20 years and all cases were involved with respiratory tract infections. Five of 8 patients were mild type and other 3 were moderate type. The mean smoking (Brinkmann) index (1194) in group A was significantly higher than that (166) in 241 asthmatic patients without lung cancer or that (169) in group B. The median survival duration (more than 26 months) of group A patients was significantly lower than that (more than 77 months) of group B. These results suggested that, in many bronchial asthma patients accompanied by primary lung cancer who have adult-typed infectious asthmatic history, smoking exposure and aging are deeply related to the development of lung cancer.

Adenocarcinoma