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Biomedical subjects

R Mikami

Publications and source records attributed to R Mikami.

At least 127 records · Page 7Linked to original sources

Long-term follow-up in sarcoidosis in Japan.

The clinical course of 775 sarcoidosis cases in Japan collected by the Japan Sarcoidosis Committee was followed up in the 6th month, 1st, 2nd, 3rd, 4th-6th, 7th-9th and 10th year and over after the first discovery. The means follow-up period was 5.5 years. The accumulated rates of disappearance of BHL, lung, eye, and whole sarcoidosis lesions calculated by life-table method were 63%, 56%, 59% and 48% respectively at the 1st year, 75% 67%, 71% and 59% respectively at the 2nd year, 79%, 71%, 76% and 64% respectively at the 3rd year, 82%, 74%, 81% and 67% respectively at the 4th-6th year. Judging from the accumulated rates mentioned above, the speakers defined the course of the disease as "good" when the whole sarcoidosis lesions cleared within 2 years. It was revealed that out of 25 factors examined, factors such as "age under 29", "no eye lesions" and "without complaints" at the time of first discovery, were significantly useful for pre-dieting the "good" results. The disappearance of BHL within 6 months was one of the most important indices predicting the "good" outcome of sarcoidosis.

Adolescent↗

Parenteral treatment of sarcoidosis with triamcinolone.

The parenteral use of triamcinolone acetonide (Kenacort A) is said to have the following advantages: to keep the effect for two weeks by one injection, to be able to reduce the total treatment dosage and to secure the dosage regardless of patients cooperation. From these reasons, a trial of the Kenacort A treatment was made for 40 cases with sarcoidosis by 7 times of intramuscular injection at two-week intervals: 80 mg each at the 1st and 2nd and 40 mg at the 3rd to 7th. The results were compared with the already reported double blind trial using the oral initial dosage of 30 mg of prednisolone followed by a a reduced dosage for a period of 6 months. This paper will give an interim report of the 4 month follow-up after the ceasation of treatment. The results showed: 1. the disappearance rate of chest findings, either BHL or parenchymal pulmonary lesions, was higher in this trial than the above-mentioned oral treatment, 2. the high rate of improvement was found in ocular lesion, and 3. side effects were less in this trial than the oral treatment.

Administration, Oral↗

A cooperative study of sarcoidosis in Asia and Africa: descriptive epidemiology.

An eight-nation cooperative epidemiological study revealed the Asian and African features of sarcoidosis. Almost every country reported from several to less than 30 cases, except for Japan which had already collected over 3,000 cases. Not a single case was found in the mass x-ray surveys conducted by several countries on a large scale (Tables 1 and 2). Although the number of the cases included in this study were small, this information is the first of this kind for Asia and Africa.

Africa↗

Clinicopathological study of fatal myocardial sarcoidosis.

Presented here was an outline of fatal myocardial sarcoidosis in Japan based on 42 autopsy cases. The incidence, clinical features, pathological findings (particularly the distribution of sarcoid lesions in various organs, and gross as well as histological patterns have been reviewed. The ratio of fatal myocardial sarcoidosis to the total number of sarcoidosis deaths is higher than that of other countries and it appears characteristic of Japanese sarcoidosis that the disease occurs here predominantly after the fourth decade in females. Only 12% of myocardial sarcoidosis cases are diagnosed exactly. Conduction disturbances and dysrhythmias due to myocardial damage are its most common manifestations. The modes of presentation or cardiac death are sudden death, 16 cases (41%); congestive heart failure, 9 cases (23.1%); Adams-Stokes syndrome, except sudden death, 7 cases (17.9%); death due to dysrhythmia, 6 cases (15.4%); and 2 pacemaker deaths among the application of pacemakers, 7 cases. As for the ECG findings, A-V block and bundle-branch block was observed in most cases and ectopic beats were also frequently observed. The difficulty in exact diagnosis of myocardial sarcoidosis appears to be due to the frequency of lack of manifestation of systemic sarcoidosis as well as insidious cardiac involvement. The gross findings on myocardial lesions showed 3 patterns and each of the localized patterns corresponded to the histological extension. The conglomerate-band-like pattern corresponded to expansive invasion, the dendrite pattern to interstitial extension. The histological findings on the myocardial lesions were classified into four types: 1) exudative type, 2) granuloma type, 3) combined type of granuloma and fibrosis, 4) fibrotic type. Two extreme cases showed the exudative and fibrotic type, respectively, and were discussed.

Adolescent↗