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Biomedical subjects

N Shigematsu

Publications and source records attributed to N Shigematsu.

At least 109 records · Page 6Linked to original sources
PubMed1990

[The significance of pleural fluid cytology in the differential diagnosis of pleurisy showing lymphocyte-predominant pleural effusion].

We examined the significance of pleural fluid cytology in differentiation between tuberculous and non-tuberculous pleurisy in patients with lymphocyte-predominant pleural effusion. We divided pleural fluid cytologic findings into two patterns, that is "tuberculous" and "non-tuberculous pattern", according to the report by Spieler, and compared the cytologic pattern with the final clinical diagnosis. Thirteen out of 19 cases (68.4%) with tuberculous pleurisy showed "tuberculous pattern" in the pleural fluid cytology, while four (pleurisy associated with collagen-vascular disease, asbestosis and carcinoma, and idiopathic pleurisy) out of 13 (30.8%) with non-tuberculous pleurisy revealed "tuberculous pattern". The pleural fluid cytology could be used as one of the additional means to differentiate between tuberculous and non-tuberculous pleurisy, though it is impossible to differentiate between them with the pleural fluid cytology alone.

Diagnosis, Differential↗
PubMed1990

[Terminal pulmonary infections in autopsy cases that died of lung cancer].

To elucidate the predisposing factors of terminal pulmonary infection in patients with lung cancer, we reviewed the case record of 251 autopsy cases that died of lung cancer in Kyushu University Hospital from 1976 to 1987. The incidence of mycobacteriosis was significantly more frequent in cases treated with antineoplastic therapy and corticosteroid (Group III) than in those with antineoplastic therapy but without corticosteroid (Group II), while the incidence of common bacterial and nonbacterial infections was not significantly different between the two groups. In patients with lung cancer treated with antineoplastic therapy, corticosteroid administration of relatively short duration (less than a month) induced fatal mycobacteriosis. In cases with lymphocytopenia, the incidence of fatal mycobacteriosis was significantly more frequent in Group III than in Group II, whereas the incidence of fatal nonbacterial infection was not. In cases with monocytopenia, both fatal mycobacteriosis and nonbacterial infection were significantly more frequent in Group III than in Group II. In Group III, the incidence of mycobacterial and nonbacterial infections was not different significantly between cases with and without lymphocytopenia or monocytopenia. Thus, in patients with lung cancer, administration of corticosteroid has greater influence on the development and exacerbation of mycobacteriosis than lymphocytopenia or monocytopenia. On the other hand, the influence of corticosteroid on the development and exacerbation of nonbacterial infection was significantly different from that of lymphocytopenia. The administration of corticosteroid and antineoplastic therapy do not increase the incidence of terminal common bacterial infection in patients with lung cancer.

Aged↗
PubMed1990

[Step section preparation of transbronchial lung biopsy material in diffuse lung disease].

We retrospectively prepared step sections of the transbronchial lung biopsy (TBLB) materials which revealed nondiagnostic findings in their original sections in patients with diffuse lung disease, and evaluated the significance of the examination of step sections in the diagnosis of diffuse lung disease. Of 131 cases with nondiagnostic TBLB findings, the preparation of step sections resulted in specific findings in 6 cases (malignancy 3 cases, tuberculosis 1 case, cryptococcosis 1 case and viral infection 1 case), and histopathological changes consistent with the clinical diagnosis in 25 cases. The step section preparation was especially useful for the detection of epithelioid granuloma and tumor tissue in patients with sarcoidosis and carcinoma, respectively, while its contribution to the diagnosis of collagen-vascular disease, hypersensitivity pneumonitis, atypical pneumonia and pneumoconiosis was relatively small. The step section preparation was also useful for the detection of bronchiolitis obliterans. In addition, step sections uncovered clinically unnoticed infection (purulent exudate in the alveolar space) in 6 cases, 3 of whom actually developed pneumonia thereafter. Thus, the preparation of step sections was considered to be useful clinically in 37 cases (28.2%). The preparation of step sections is recommended before a further diagnostic procedure is chosen, when TBLB performed in patients with diffuse lung disease reveals nondiagnostic findings.

Biopsy↗
PubMed1990

[Hypoxemia of liver cirrhosis--an autopsy case study].

41 year-old male with liver cirrhosis accompanying severe hypoxemia was presented. Shortly after the diagnosis of liver cirrhosis, he suffered from exertional dyspnea and cyanosis. Though home oxygen therapy had been prescribed for 2 years, hypoxemia gradually progressed accompanied by persistent cough, mucous sputa and intermittent fever. The chest X-ray revealed bilateral interstitial shadow particularly localized in lower lung fields. The arteriovenous shunt ratio was shown to be 24% by oxygen method. Perfusion lung scan using 99mTc-labeled MAA revealed perfusion defects in bilateral lung fields and radionuclide uptake was strongly demonstrated in the kidneys. These clinical data suggested that severe hypoxemia was probably due to multiple arteriovenous shunt. With further progression of hypoxemia for 4 months, he died of hepatic failure and pulmonary infection. Autopsy showed Miyake's type B cirrhosis. Multiple pleural and subpleural arteriolar nevi were demonstrated grossly and microscopically. There were no arteriovenous malformations demonstrated after injection of barium-gelatin solution into the pulmonary artery. Histologically, irregularly dilated vessels were found in the lung parenchyma beneath the pleura and filled with blood and injection material. These clinical and pathological findings provided evidence that the mechanism of arterial desaturation was pulmonary arteriovenous shunting due to liver cirrhosis.

Adult↗
PubMed1990

[Basic and clinical evaluation of rapid diagnosis of tuberculosis by detecting tuberculostearic acid].

Tuberculostearic acid (TSA) is known to be one of the characteristic lipid in the limited species of the order Actinomycetale, including Mycobacterium tuberculosis. We studied the significance of detecting TSA in the diagnosis of tuberculosis from clinical specimens collected from 791 patients with various respiratory diseases by using gas--chromatography/mass--spectrometry. By our method, the detectable limit of TSA was around 10(2)-10(3) bacilli of Mycobacterium tuberculosis, and our method is as sensitive as culture examination for tuberculosis. In sputa collected from patients with active pulmonary tuberculosis (n=169), TSA positively was around 90%, while less than 10% false positive ws also recognized. In pleural effusion (n=81) and bronchial washing (n=91) collected from patients with active tuberculosis, the positivity of TSA was around 70%. We could also detect TSA in about 30% of clinical specimens collected from patients suspected of tuberculosis. The diagnostic sensitivity of TSA for tuberculosis was similar to that of adenosine deaminase activity (ADA), while TSA was slightly superior to ADA in specificity. These findings indicate that detection of TSA from clinical specimens is useful to make rapid diagnosis of pulmonary tuberculosis.

Bronchoalveolar Lavage Fluid↗
PubMed1990

[Contribution of the vagal nerve on histamine-induced bronchoconstriction in guinea-pigs].

Recently, it has been suggested that the peripheral vagal nerve might participate in the bronchoconstriction locally in addition to the concept of "vagal reflex". We investigated the contribution of the vagal nerve on the modulation of airway responses to histamine (8 micrograms/kg, iv) in anesthetized and mechanically ventilated guinea-pigs. Airway responses were assessed by measurement of pulmonary resistance (RL). To determine whether the vagal nerve mediates excitatory effects by "vagal reflex" in guinea-pigs, we investigated the effects of vagotomy or hexamethonium (2 mg/kg, iv). Increase in RL induced by histamine was significantly enhanced after the vagotomy or the treatment of hexamethonium. Histamine-induced bronchoconstriction was also enhanced by the vagotomy in the animals after the administration of propranolol (1 mg/kg, iv). To determine whether the peripheral vagal nerve may play any role in the vagotomized animals, we investigated the effect of atropine (1 mg/kg, iv). Atropine reduced histamine-induced bronchoconstriction significantly in the vagotomized guinea-pigs or in the animals treated with hexamethonium. We conclude that the vagal nerve mainly exerts on inhibitory role through the central nervous system, and that the peripheral vagal nerve distal to ganglion plays an excitatory effects by releasing acetylcholine from the terminals in histamine-induced bronchoconstriction in guinea-pigs.

Animals↗
PubMed1990

[The effect of OK-432 on modifying a spontaneous lung metastasis from murine fibrosarcomas].

The authors have investigated the effect of OK-432 on the spontaneous metastasis from a murine fibrosarcoma, either an NFSA or a SANH, that had been transplanted into the right thigh of C3H mice. When the NFSA or the SANH tumors grew to 7 mm in diameter, they were irradiated with a single dose of 30 Gy and 20 Gy, respectively. A local administration of OK-432 (2.5 KE) around each of the tumors was initiated immediately after irradiation and continued twice a week. It was found that regrowth in both tumors was not modified by the OK-432, though the mean number of metastatic lung nodules per mouse from either tumor was significantly decreased. The incidence of a lung metastasis also was reduced by the OK-432 but not significantly. Further, mice that had received a SANH tumor transplant developed a lymph node metastasis in the abdominal cavity that was depressed by the OK-432.

Animals↗
PubMed1989

[Results of the treatment of Hodgkin's disease: the importance of establishing and executing a protocol].

A retrospective analysis was performed on 32 patients seen at Keio University Hospital and its affiliated hospitals from 1976 to 1987. Twenty-two patients were treated with our protocol, and the other 10 were not for several reasons. In this study, we compared the results of the treatment of these two groups. There were 20 males and 12 females. Age ranged from 13 to 72 years with a median value of 36 years. Histologically, six had lymphocytic predominance, 12 nodular sclerosis, 14 mixed cellularity. In the protocol group, seven were clinical stage I, 12 were CS II, two were CS III, and one was CS IV. Nine patients in the protocol group underwent staging laparotomy, and four CS II patients were upstaged to PS III. In the non-protocol group, five were CS I, four were CS II, one was CS III. According to the protocol, staging laparotomy was done excepting CS III.IV patients and some of CS I patients. In case of CS I without laparotomy, pathological stage(PS) I.II, or PS III1 with minimal splenic involvement, they were treated with radiation only. The rest of the patients were treated with chemotherapy and booster irradiation. Ten-year survival and 10-year relapse-free survival were 100%, 75%, respectively in the protocol group. In the non-protocol group, they were 31% and 32%, respectively. When picking up 17 patients treated by the authors through the whole process, 10-year survival and 10-year relapse-free survival were 100%, 92%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Thrombosis-inducing activity found in plasma from two patients with advanced lung cancer.

In 2 patients with lung cancer, the coagulation system was supposed to be activated by the findings of elevation of plasma fibrinogen, fibrinogen degradation product (FDP) and/or peripheral platelet counts. The plasma thromboxane B2 and 6-keto-prostaglandin F1 alpha levels in 1 patient were measured and proved to be 160 and 20 times higher than the control level, respectively. When 0.5 ml of plasma from each patient was given intravenously into Balb/c mice, the mice died within 5 min. The multiple thrombosis mainly composed of aggregated platelets and present in the lungs of these mice probably led to death of these animals. On the contrary, no such activity was found in plasma from healthy subjects or other patients with lung cancer who showed no manifestations of enhancement in the coagulation system.

Adenocarcinoma↗
PubMed1989

Measurement of lung density by computed tomography: implication for radiotherapy.

In order to achieve practical application for the treatment planning of radiotherapy, lung density was assessed by means of CT. Cork phantoms were measured 360 times to test the reliability of CT densitometry. Densities were corrected by the CT value of pure water measured at the same time. The mean value of cork phantoms as measured by CT was 0.287 +/- 0.11 g/cm3, the true value of which was 0.320 g/cm3. These errors were within an allowable limit for radiotherapy. Lung density was studied in 50 patients with a mean age of 50 years, ranging from 46 to 76. The values obtained of the upper, middle, and lower lung were 0.123 +/- 0.46 g/cm3, 0.121 +/- 0.033, and 0.154 +/- 0.057 g/cm3 during inspiration and were 0.215 +/- 0.058 g/cm3, 0.228 +/- 0.066, and 0.260 +/- 0.078 g/cm3 during expiration, respectively. The dorsal, central, and ventral portions of the lung were measured simultaneously with a patient on supine position. In order to hold the variation of radiation dose within 2%, the variation must be kept within 30 HU of CT value. As for the upper lung, the difference of which between both subjects and sites was smallest during inspiration in this results, that was 20%; the difference of 60 HU CT value existed between the dorsal and ventral lungs. Variations in CT number between subjects were more than 60 HU in one third of this series. Before starting radiotherapy to the lung field, lung densitometry is warranted in order to irradiate the exact dose.

Adult↗
PubMed1989

WS-9659 A and B, novel testosterone 5 alpha-reductase inhibitors isolated from a Streptomyces. II. Structural elucidation of WS-9659 A and B.

On the basis of spectroscopic and chemical evidence, the structures of WS-9659 A and B isolated as inhibitors of testosterone 5 alpha-reductase from a Streptomyces have been established as 1 and 2, respectively. The reductase inhibitory activities of the derivatives 5 and 6, and degradation products 3 and 8 were considerably less active and substantially inactive, respectively.

5-alpha Reductase Inhibitors↗
PubMed1989

[Morphology of 3,4,5,3',4'-pentachlorinated biphenyl-induced change in canine lung].

We investigated the light and electron microscopical changes of the lung in dogs treated with 3,4,5,3',4'-pentachlorinated biphenyl (PenCB). Beagle dogs were orally administered with 0.1 mg/kg of PenCB, and sacrificed 3, 5 and 7 weeks after the PenCB administration. Light microscopically, bronchiolar epithelial cells showed cytoplasmic vacuolization, which was most prominent 5 weeks after the PenCB administration. Electron microscopically, nonciliated bronchiolar epithelial cells (Clara cells) revealed degradation of glycogen particles, swollen, irregularly arranged smooth endoplasmic reticulum, and swollen mitochondria, while no significant change was found in other epithelial cells. The endothelial cells also showed no significant change except for increased number of cytoplasmic vesicles. This is a first report on halogenated hydrocarbon-induced degradation of glycogen particles in Clara cells.

Animals↗
PubMed1989

[Comparison of high resolution computed tomography and pulmonary function tests in diagnosis of mild emphysema].

To assess the ability of high resolution CT scan and pulmonary function tests in detecting and grading mild emphysema, we correlated the high resolution CT scan and pulmonary function tests with the pathologic grade of emphysema and the destructive index of lung specimens from 42 patients undergoing thoracotomy for solitary pulmonary nodules. Using the high resolution CT scan, we could identify the pathologic grade of mild and moderate emphysema. By measuring diffusing capacity per unit alveolar gas volume (DLco/VA), it seemed to be possible to detect the mildest degree of alveolar destruction assessed by the destructive index, which was not detected by high resolution CT scan. The reason for these results seemed to be that we assessed the severity of emphysema by detecting the air space enlargement on high resolution CT scan images caused by the destruction of alveolar walls, which were detectable by measuring DLco/VA. We conclude that it is possible to detect mild emphysema using the combination of high resolution CT scan and pulmonary function tests.

Adult↗
PubMed1989

[Autopsy cases of terminal pulmonary infections].

In order to clarify the present state of terminal pulmonary infections, all autopsy cases from 1976 to 1985 reported in the annual records of autopsy cases in Kyushu University Hospital were reviewed. Of the total of 2,238 autopsy cases, pulmonary infections were present in 1,042 (46.6%) and in 595 (26.6%) pulmonary infections were fatal. Among the primary diseases associated with pulmonary infections, hematologic diseases such as leukemia and malignant lymphoma, lung cancer, esophageal cancer and cerebrovascular disease were most frequent. The pathogens of fatal pulmonary infections occurring in autopsy cases were bacteria (26.6%), Aspergillus (3.2%), Candida (1.8%), cytomegalovirus (1.7%), Pneumocystis carinii (1.1%), Mycobacterium (0.9%), Cryptococcus (0.6%) and phycomycetes (0.1%). The incidence of non-bacterial, especially fungal, pulmonary infections has increased during the recent five-year period. Among the pulmonary infections associated with lung cancer in autopsy cases, mycobacteriosis occurred more frequently than fungal infection. The incidence of fatal mycobacteriosis was more frequent in cases receiving steroids than in those not receiving steroids. Antemortem diagnosis of pulmonary infections was made in only 4.6% and 26.3% of cases of non-bacterial infection and mycobacteriosis, respectively. There was no autopsy case diagnosed before death as aspergillosis, which most frequently occurred among the fungal pulmonary infections in autopsy cases.

Bacterial Infections↗
PubMed1989

Noninvasive superfusion of canine tracheal segment to study prostaglandin release in vivo.

To be able to study the release of mediators from the canine trachea noninvasively in vivo, we modified an endotracheal tube to allow superfusion of the lumen of an isolated segment of trachea. We tested this apparatus by measuring prostaglandin E2 (PGE2) output in the presence and absence of a stimulant (bradykinin) and a blocker (indomethacin) and comparing the results with results of in vitro studies. We found that PGE2 output increased with time over the 180 min of the study. Bradykinin (10(-5) M) applied to the luminal surface increased PGE2 output markedly. Indomethacin (10(-5) M) decreased PGE2 and prevented the usual increase in PGE2 caused by bradykinin. These findings are qualitatively similar to those for in vitro experiments. We conclude that this apparatus can be used to measure the release of mediators from the trachea of dogs noninvasively in vivo.

Animals↗
PubMed1989

[Fibrin deposition and fibrinolysis in the pathogenesis of pulmonary fibrosis].

Fibrin deposition is prominent in the course of several forms of pulmonary fibrosis. To elucidate the role of fibrin deposition and fibrinolysis in the process of pulmonary fibrosis, we studied bleomycin-induced fibrosis and the effect of urokinase on it. Beagle dogs were injected intramuscularly 20 times with bleomycin in doses of 2 and 6 mg/kg body weight every other day. Intravenous urokinase treatment was subsequently performed with 3,000 units daily for 40 days and 9,000 units twice daily for 70 days. Histopathologic examination of the lungs of dogs receiving bleomycin alone revealed fibrosis. The lungs of bleomycin-treated dogs which received urokinase had less severe fibrosis and this was confirmed by morphometry with planimetry and the point counting method. Urokinase treatment also diminished the increase of hydroxyproline content of the lung of bleomycin-treated dogs. Decrease of lung tissue fibrinolytic activity assayed by fibrin plate method in bleomycin-treated dogs was also prevented by urokinase. Intravenous urokinase, 24,000 units per day in divided doses, was administered daily in cancer patients with bleomycin treatment. Incidence of pulmonary fibrosis was decreased by urokinase. These data indicate that fibrin deposition and fibrinolysis may have an important influence on the fibrotic process in the lung.

Animals↗
PubMed1989

[Membranous bronchiole diseases in patients without chronic air-flow limitation].

In order to investigate the relationship between pulmonary function and diseases involving membranous bronchioles (MB), we measured airway diameters and quantitated airway pathology scores in MB in 35 patients who required surgery for removal of a solitary nodule. The patients had FEV1 greater than 80% of the predicted value. Measurements of FEV1, nitrogen washout curve (delta N2/L), closing volume as a percentage of vital capacity (CV/VC%), and maximal flow rate at 50% of VC (V50) were made prior to the surgery. There were 21 smokers and 14 nonsmokers. There was 1.02 MB per cm2 of tissue. The mean internal diameter for MB cases was 0.55 +/- 0.05 mm. The total pathology scores for all MB cases were less than those found in North American populations. Inflammation scores were higher in patients with FEV1 less than 100% that of the predicted (p less than 0.05). FEV1 values correlated with goblet cell metaplasia (p less than 0.05). Tests specific for small airways did not correlate with the pathology scores in MB. We concluded. In 35 Japanese cases some diseases in MB were detected among cases whose average age was 59.5 years (42-78 yrs) and whose FEV1 was greater than 80% of the predicted value. The disease showed little effects of smoking and it was relatively minor in comparison with North American cases. This degree of abnormality is considered to be found in normal Japanese as well. It is supposed that an ordinary pulmonary function test would not reveal this abnormality in MB.

Adult↗