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Biomedical subjects

N Shigematsu

Publications and source records attributed to N Shigematsu.

At least 73 records · Page 4Linked to original sources
PubMed1992

Adverse effect of chronic tonsillitis on clinical course of sarcoidosis in relation to HLA distribution.

We examined the effect of chronic inflammatory foci in the upper respiratory tract and/or HLA class 2 antigens on the clinical course of sarcoidosis. Sarcoidosis resolved spontaneously in 6 of 27 (22 percent) patients with CTL and in 19 of 29 (66 percent) without CTL (p less than 0.01). The clinical course became favorable after TLT in 7 of 14 cases with CTL. Patients with HLA-DR9 and DRw8 showed the highest ratio of patients who had protracted clinical course; those with HLA-DR2, DR5 and DR6 showed the lowest; and those with HLA-DR4, DRw52 and Drw53 were between these levels. A high responsiveness to SCW antigens was seen more frequently in sarcoidosis patients with protracted clinical course. The high responsiveness to SCW antigens was related to HLA-DR4, DRw8, DR9 and DRw53 in sarcoidosis patients. HLA antigens, especially HLA-DR, modulate the immune response to inhaled antigenic agents. Immune response seemed to affect the clinical course of sarcoidosis.

Adult↗
PubMed1992

Pleural SC5b-9 in differential diagnosis of tuberculous, malignant, and other effusions.

A monoclonal antibody against soluble phase-terminal complement complex (SC5b-9) was used to try to differentiate pleural effusions of tuberculous vs malignant and other origin. Effusions of tuberculous origin showed a significantly higher SC5b-9 level than did plasma, suggesting activation of complement in the pleural space. All 26 patients with tuberculous effusions showed SC5b-9 levels in pleural fluid exceeding 2.0 mg/L, while 20 with malignant effusions had levels less than 2.0 mg/L. However, rheumatoid, some parapneumonic, and treated malignant effusions showed SC5b-9 levels above 2.0 mg/L. Considering a value exceeding 2.0 mg/L, the specificity and sensitivity of the SC5b-9 estimation in tuberculosis were 0.74 and 1.0, respectively. The mean values for C4d and Bb fragments of complement were significantly (p < 0.05) higher in the tuberculous than in the malignant effusions. However, the values for Bb in 16 (62 percent) of the 26 patients with tuberculous or malignant effusions were in the same range. The activity of adenosine deaminase (ADA) was higher in the tuberculous than in the malignant effusions. While 18 of 26 patients with tuberculous effusions showed an ADA value exceeding 50 mU/ml, the estimated cutoff point (sensitivity = 0.69), 35 of the 36 nontuberculous effusions showed a true negative value (specificity = 0.97). A correlation between ADA and SC5b-9 values was observed in pleural effusions. These observations suggest that the estimation of SC5b-9 in pleural fluid presents a new approach to differentiating tuberculous vs malignant effusions.

Adenosine Deaminase↗
PubMed1992

The usefulness of step sectioning of transbronchial lung biopsy specimen in diagnosing sarcoidosis.

To evaluate the usefulness of step sectioning of the transbronchial lung biopsy (TBLB) specimens obtained from patients with suspected sarcoidosis, we examined all TBLB specimens obtained from 132 patients who were diagnosed clinically as having sarcoidosis at our institute. When routine sections of TBLB specimens did not show sarcoid granuloma, we prepared additional serial sections from each block and stained every fifth section with hematoxylineosin (step sectioning). All step sections were examined histologically. With the aid of step sectioning, the diagnostic yield of sarcoidosis increased from 38 percent (18/47) to 47 percent (22/47) in stage 1 patients, and from 57 percent (37/65) to 82 percent (53/65) in stage 2 patients. All of the newly detected granulomas were identified between the first and seventh sections. We conclude that step sectioning is useful method in diagnosing sarcoidosis.

Aged↗
PubMed1992

Simultaneous measurements of adenosine deaminase activity and tuberculostearic acid in pleural effusions for the diagnosis of tuberculous pleuritis.

Adenosine deaminase (ADA) activity and tuberculostearic acid (TSA) levels in pleural effusions were measured in 18 patients with active tuberculous pleuritis, 16 patients suspected of having tuberculous pleuritis, 14 patients with carcinomatous pleuritis, and 19 patients suffering from pleuritis of non-malignant and non-tuberculous etiology. In the patients with active tuberculous pleuritis, ADA was elevated in 56% and TSA was positive in 78%. In 83% of these patients, either ADA was elevated or TSA was positive. ADA was elevated together with a positive TSA in 50%. In contrast, TSA was positive in only 6% and ADA was elevated in 24% of the patients with non-tuberculous pleuritis, and none of these patients showed the combination of an elevation of ADA and a positive TSA. These results suggest that simultaneous measurements of both ADA and TSA in pleural effusions are useful for the diagnosis of tuberculous pleuritis.

Adenosine Deaminase↗
PubMed1992

WS9326A, a novel tachykinin antagonist isolated from Streptomyces violaceusniger no. 9326. I. Taxonomy, fermentation, isolation, physico-chemical properties and biological activities.

Data from several studies suggest that tachykinins may play an important role in the pathophysiology of airway diseases, especially asthma. Our aim is to discover tachykinin antagonists which exhibit therapeutically useful anti-asthmatic activity. In our search for activities inhibiting the binding of [3H]substance P to guinea-pig lung membrane preparations, we have found that the fermentation product, WS9326A, isolated from Streptomyces violaceusniger, is a potent tachykinin receptor antagonist.

Animals↗
PubMed1992

WF11605, an antagonist of leukotriene B4 produced by a fungus. II. Structure determination.

The structure of WF11605, a novel tetracyclic triterpene glucoside, was determined to be 1. The plane structure of deacetyl-WF11605 aglycone was elucidated as 2 through the concerted application of a series of 2D NMR techniques. The relative configurations were established by X-ray crystallographic analysis of bis(p-bromobenzoyl) derivative 3 and absolute stereochemistry by CD exciton chirality method.

Chrysenes↗
PubMed1992

[A comparison of community-acquired lung infection and nosocomial infection--review of autopsy cases in Hisayama town].

All people in Hisayama town who died either at home or in hospital are autopsied in Kyushu University Hospital. We examined the incidence and the pathogen of community-acquired lung infection and nosocomial infection from the records of 463 autopsy cases from 1977 to 1988. Of these cases, 243 died at home. Among them, pulmonary infections were present in 122 cases (50.2%), and pulmonary infection was the cause of death in 87 cases (35.8%). Of 220 cases that died in hospital, pulmonary infections were present in 133 cases (60.5%) and were the cause of death in 83 cases (37.7%). In the cases that died at home, the incidence of pulmonary infections during the first 6-year period of the study was almost the same as that during the last 6 years. In the case that died in hospital, the incidence of pulmonary infections during the last 6-year period was higher than that during the first 6-year period. Regarding the pathogenic organisms of the fungal infections, only Candida was detected in case that died at home, while Candida, Aspergillus and Cryptococcus were detected in the case that died in hospital.

Aged↗
PubMed1992

[Evaluation of plasma SC5b-9 (SMAC) in patients with ARDS].

The adult respiratory distress syndrome (ARDS) occurs in patients with various underlying illnesses. It has been suggested that complement activation may play a crucial role in the pathophysiology of ARDS by direct actions of complement fragments and/or by release of mediators including endotoxin, superoxide anion, and arachidonate metabolites. Therefore, complement evaluation was performed in patients with ARDS, with emphasis on SC5b-9 (Membrane Attack Complex). Complement split products, C4d, Bb, and SC5b-9, respectively from the classical, alternative, and terminal complement pathway were measured by enzyme immunoassay (EIA) using respective monoclonal antibodies. Plasma S-protein (vitronectin) concentration was also evaluated by EIA. We could not detect SMAC in normal controls or in a C5-deficient patient with abdominal infection. In contrast, most patients with ARDS and patients at risk showed elevated SMAC, and an increase in the values in association with exacerbation of the disease. However, two patients with ARDS exhibited lower values of SMAC in spite of deterioration and subsequent death. It was suggested that in these two ARDS patients, liver dysfunction may have contributed to the reduced SMAC formation. The finding that S-protein concentration (a MAC inhibitor) in the plasma of these two patients was reduced supports this speculation. It is suggested that simultaneous evaluation of SMAC and S-protein in plasma is helpful in determining the prognosis of critically ill patients.

Adolescent↗
PubMed1991

Simultaneous assay of the activities of two key enzymes in cholesterol metabolism by gas chromatography-mass spectrometry.

A very sensitive and specific method for the simultaneous assay of the activities of two key regulatory enzymes in cholesterol metabolism, 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase (EC 1.1.1.34), and cholesterol 7 alpha-hydroxylase (EC 1.14.13.7), is described. The assay is based on the measurement of [2H3]mevalonolactone and 7 alpha-hydroxycholesterol produced by the incubation of [2H3]HMG-CoA and endogenous cholesterol with hamster liver microsomes using isotope dilution mass spectrometry. The incubation mixture was purified by means of solid extraction cartridges, and the extract was treated with benzylamine followed by dimethylethylsilyl imidazole. The resulting ether derivatives of the mevalonylbenzylamide and 7 alpha-hydroxycholesterol were quantified by gas chromatography-mass spectrometry with selected-ion monitoring in a high resolution mode. The method made it possible to assay simultaneously the activities of HMG-CoA reductase and cholesterol 7 alpha-hydroxylase in hamster liver microsomes with high sensitivity and accuracy.

Animals↗
PubMed1991

High dose rate intracavitary brachytherapy for recurrent cervical cancer of the vaginal stump following hysterectomy.

Forty-eight patients with recurrent cervical cancer of the vaginal stump following hysterectomy for cervical cancer, were treated with high dose rate intracavitary brachytherapy with or without external irradiation. The intervals between primary surgery and vaginal recurrences varied widely from 3 months to 36 years. Patients were classified into two groups, either with or without palpable tumor of the vaginal stump. Tumor size was determined by bimanual rectovaginal examination at the time of recurrence. Survival rates were 8% for the group with palpable tumors and 80% for those without, respectively. The survival rate of patients who did not have palpable masses and were treated with brachytherapy alone was not improved by combination with external irradiation. The time interval from the primary hysterectomy to the recurrence did not influence survival. These results suggest that the only significant prognostic factor for recurrent cervical cancer after hysterectomy is tumor size. The relationship between recurrent cervical cancer of the vaginal stump and second primary vaginal cancer is also discussed.

Adult↗
PubMed1991

Clinicopathological study of migratory lung infiltrates.

Clinical features and the histological appearances of transbronchial lung biopsy specimens were investigated in 11 patients with migratory infiltrates on the chest radiograph. Serum circulating immune complexes were increased at the time that infiltrates were present in all patients and the levels returned to normal as patients recovered clinically and radiologically. The Mantoux test response was negative in most patients. Fifty serial sections were obtained from each paraffin embedded biopsy specimen block and every 10th section was stained (step sectioning) with haematoxylin and eosin. Six patients (group 1) did not have eosinophilic infiltration; four of these had granulation tissue plugs within respiratory bronchioles when the tissue was examined by step sectioning. All had organising pneumonia and interstitial inflammation in the setting of a clinical picture consistent with bronchiolitis obliterans organising pneumonia. In two cases IgG had been deposited in intraalveolar macrophages. Biopsy specimens in five patients (group 2) showed eosinophilic infiltration; four patients had chronic eosinophilic pneumonia and one the Churg-Strauss syndrome. Step sectioning of transbronchial biopsy specimens in patients with migratory pulmonary infiltrates is useful and may support the diagnosis of bronchiolitis obliterans organising pneumonia.

Aged↗
PubMed1991

Step section preparation of transbronchial lung biopsy. Significance in the diagnosis of diffuse lung disease.

We retrospectively prepared step sections of nondiagnostic TBLB materials obtained from patients with diffuse or multiple lung disease and evaluated the diagnostic significance of the step section method. Among 112 patients with nondiagnostic TBLB findings, the preparation of step sections resulted in specific findings in seven cases. Step sections were especially useful for the detection of epithelioid granulomas and tumor tissue in patients with sarcoidosis and lymphangiosis carcinomatosa, respectively, but their contribution to the diagnosis of hypersensitivity pneumonitis, collagen-vascular disease, Mycoplasma pneumonia and pneumoconiosis was relatively small. In addition, step sections were useful for the detection of bronchiolitis obliterans affecting respiratory bronchioles. Overall, the examination of step sections was considered to be clinically useful in 30 cases (26.8 percent). Accordingly, the examination of step sections can be recommended before a further diagnostic procedure is chosen, if a TBLB performed in patients with diffuse or multifocal lung disease is nondiagnostic.

Biopsy↗
PubMed1991

Adverse effect of chronic tonsillitis on clinical course of sarcoidosis.

Sarcoidosis resolves spontaneously in many cases on a long-term basis. However, there are many cases whose resolution is delayed. We have experienced a frequent association of chronic tonsillitis (CTL), and dental caries in those patients of persistent course. We hypothesized that the presence of chronic or recurrent inflammatory foci in the upper airway may adversely affect the natural resolution of sarcoidosis. We analyzed the difference of regression of bilateral hilar lymphadenopathy on chest roentgenogram (CXR) in relation to changes in serum angiotensin converting enzyme (SACE) in sarcoidosis patients with and without CTL, and the effect of tonsillectomy (TLT) on the clinical course. In this study, we focused only on the tonsil for the sake of simplicity of analysis. Sarcoidosis resolved spontaneously in 10 of 28 (36%) patients with CTL and in 19 of 25 (76%) without CTL, and after TLT 9 cases became favorable in the course and the rate of unfavorable turned similar to those without CTL. The presence of CTL may be adversely related to the resolution of sarcoidosis.

Adolescent↗
PubMed1991

Possible roles of the peripheral vagal nerve in histamine-induced bronchoconstriction in guinea-pigs.

Although the importance of the vagal nerve in the pathogenesis of bronchial asthma has been reported, its precise contribution is still not fully understood. To shed more light on this area, we evaluated the possible contribution of vagal reflex in histamine-induced bronchoconstriction (HIB), and decided the site of action of histamine on the vagal nerve. For this purpose, we studied the effects of the bilateral cervical vagotomy, hexamethonium (2 mg.kg-1) or tetrodotoxin (0.5 mg.kg-1) on HIB (8 micrograms.kg-1, iv) in anaesthetized and mechanically-ventilated guinea-pigs. We also studied whether or not atropine (1 mg.kg-1) decreases HIB after vagotomy, including either the treatment of hexamethonium or tetrodotoxin. Airway responses were assessed by measurement of pulmonary resistance. The following results were obtained; 1) the response to histamine was significantly enhanced by the vagotomy, hexamethonium or tetrodotoxin; 2) propranolol increased HIB, and HIB was further enhanced by the vagotomy in the animals treated with propranolol; 3) atropine significantly suppressed HIB after the vagotomy, hexamethonium or tetrodotoxin. These results suggest that the postganglionic vagal nerve plays an excitatory role in HIB through the release of acetylcholine from the nerve terminals. It is also suggested that the vagal reflex mainly exhibits an inhibitory role in the HIB of guinea-pigs, presumably by the action of the nonadrenergic inhibitory nervous system.

Animals↗
PubMed1991

Effect of cyclooxygenase inhibitor on excessive sputum.

Indomethacin suppository and aspirin inhalation reduced the amounts of sputum in the patients with bronchiectasis and chronic bronchitis. A 67-year-old woman with bronchiectasis received indomethacin suppository to relieve the lumbar pain. After the start of indomethacin, a reduction in the amount of sputum was observed and the volume of sputum returned to pretreatment levels after the cessation of indomethacin. Levels of cyclooxygenase products in the sputum during indomethacin was also much lower than their levels after discontinuance of indomethacin. A 64-year-old man with chronic bronchitis was also administered inhaled aspirin to control the sputum volume. Both indomethacin suppository and aspirin inhalation reduced the amounts of sputum. In addition to these cases, a 31-year-old woman with bronchial asthma was tried to control the sputum production with indomethacin, but it had no effect on the sputum volume. It is suggested that these drugs may be useful in the treatment of excessive sputum in bronchiectasis and chronic bronchitis.

Adult↗
PubMed1991

[Carcinogenic effects of polychlorinated biphenyls (PCBs) and their derivatives, including carcinogenicity to the lung].

PCBs are compounds whose physical/chemical properties led to their wide spread commercial use. The persistence and stability of PCBs have resulted in a world wide distribution. PCDFs, ones of PCB derivatives, are primary causal agents of mass food poisoning, called Yusho in Japan and Yu-Cheng in Taiwan. Several epidemiologic studies on the carcinogenicity of PCBs in both occupational exposure and accidental intoxication suggest that PCBs might be a potent carcinogen in liver and lung. Many investigators reported that PCBs induced hepatocellular carcinoma in rat and mice. Although either mutagenic or genotoxic effects of PCBs are not definite, their tumor promoting effects have been repeatedly demonstrated in the liver. The effects of PCBs as tumor promoter in the lung have also been reported. PCB congeners that efficaciously promote carcinogenesis increase cytochrome P-450-dependent monooxygenases, which are abundant both in bronchiolar Clara cells and in hepatocytes. PCB congeners which are inducers of P-450 may be active as tumor promoter by inhibiting intercellular communication and/or by stimulating cell proliferation. Furan derivatives like PCDFs have high affinity to bronchiolar Clara cells and hepatocytes. PCDFs induce necrosis and epoxide formation to their target cells, which might result in carcinogenesis of liver and lung.

Animals↗