Biomedical subjects
R Soejima
Publications and source records attributed to R Soejima.
[Primary racemose hemangioma of bronchial artery].
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[Changing pattern of Chlamydia respiratory tract infections--with special reference to infections in Japan].
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[Reactivity of Chlamydia pneumoniae strains in the IDEIA CHLAMYDIA test kit designed for detection of Chlamydia trachomatis].
The intensity of reaction in the IDEIA CHLAMYDIA test kit to lipopolysaccharide of seven strains of Chlamydia pneumoniae was examined by using highly purified elementary bodies (EBs). The strains were divided into two groups according to whether the EBs were pear-shape or round. The group with the pear-shaped EBs consisted of TW-183, AR-39 and AR-388 strains; the group with the round EBs consisted of IOL-207, Kajaani-6, YK-41 and KKpn-1 strains. The number of EBs at the cutoff level of the test kit were determined as follows: TW-183, 7.0 x 10(3); AR-388, 8.4 x 10(3); AR-39, 2.4 x 10(4); IOL-207, 6.0 x 10(3); Kajaani-6, 1.2 x 10(4); KKpn-1 2.8 x 10(4); and YK-41, 4.0 x 10(4) per assay. The number of EBs of C. trachomatis L2/434/Bu and C. psittaci Cal 10 were 1.0 x 10(3) and 2.7 x 10(4) per assay, respectively. The results demonstrated that the EBs of C. pneumoniae were detected with the test kit at different reaction intensities ranging from 6.0 x 10(3) to 4.0 x 10(4) per assay and that there was no correlation between EB number and morphology.
[Studies on effects of new quinolones on superoxide production--with special reference to NADPH oxidase].
The effects of nalidixic acid (NA) and various new quinolones, such as norfloxacin (NFLX), ofloxacin (OFLX), tosufloxacin (TFLX), lomefloxacin (LFLX) and temafloxacin (TMFX), on the superoxide production of human neutrophil NADPH oxidase were investigated. In their therapeutic concentrations, NA, NFLX and OFLX had no significant effects on superoxide generation of NADPH oxidase. However, TFLX, LFLX and TMFX increased superoxide production by about 130 percent. Fifty microM NA increased superoxide production by 130 percent. Recently, it has been reported that NA and the new quinolones have toxic side effects on the central nervous system. In this report, relationships between toxic side effects of the new quinolones and superoxide production were discussed.
In vitro and in vivo antichlamydial activities of newly developed quinolone antimicrobial agents.
The in vitro and in vivo activities of three newly developed quinolone antimicrobial agents (sparfloxacin, tosufloxacin, and OPC-17116) were investigated. All three agents showed potent in vitro activities against Chlamydia psittaci, C. trachomatis, and C. pneumoniae with MICs that ranged from 0.031 to 0.125 micrograms/ml. These values were higher than those of minocycline (0.0075 to 0.015 micrograms/ml) but lower than those of erythromycin (0.25 to 0.5 micrograms/ml) and ofloxacin and ciprofloxacin (0.5 to 1.0 micrograms/ml). Mice were challenged with 10(5) inclusion-forming units of C. psittaci each by nasal instillation. All untreated control animals died within 7 days. The survival rates of mice treated with 40 mg of sparfloxacin, OPC-17116, or tosufloxacin per kg of body weight every 12 h for 7 days were 73, 73, and 60%, respectively, 7 days after the challenge. The survival rate of mice treated with ofloxacin at the same dosage was 53%. On the basis of the above results, we concluded that these three new quinolones might be useful in the treatment of chlamydial respiratory infections.
Current topics of chlamydial respiratory tract infections--special reference to the epidemiology and clinical findings of Chlamydia pneumoniae infections in Japan.
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[Nonsurgical treatment of bronchiectasis and pulmonary abscess].
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[A case of rheumatoid arthritis accompanied by repeated pleural effusion associated with rapid tapering of steroid].
A 65-year-old woman was referred to our department because of general fatigue and anorexia for one month. The patient has received anti-rheumatoid therapy with aurothiomalate and bucillamine for the last two years for rheumatoid arthritis diagnosed 11 years earlier. Based on her systemic arthralgia, positive RA factor, and characteristic pleural effusion, the diagnosis of rheumatoid pleural effusion was made and prednisolone was administered. Two weeks later, the pleural effusion had improved. Rapid tapering of the drug over one month resulted in reappearance of pleural effusion. Slow tapering of prednisolone resulted in disappearance of the pleural effusion. One year after discharge, the patient was again referred to our department because of increased arthralgia. Pleural effusion reappeared after similar rapid tapering of the drug. These results suggest that induction of pleural effusion may occur in rheumatoid arthritis patients as a result of rapid tapering of steroids. Tapering of steroids in rheumatoid patients should be performed with care.
[A case of chronic myelogenous leukemia with pulmonary aspergillosis diagnosed by the detection of circulating Aspergillus antigen].
Immunocompromised hosts usually develop invasive mycotic disease. Among many pathogenic fungi. Aspergillus spp, is the most common pathogen of respiratory infection. Early diagnosis of invasive type pulmonary aspergillosis is still difficult, and the treatment is usually difficult. Many investigations have recently suggested that detection of Aspergillus antigen from sera of the patients is useful for early diagnosis to save their lives. We have experienced a case diagnosed by the detection of circulating Aspergillus antigen by Pastorex Aspergillus, who was a 64-year-old female with the blastic crisis chronic myelogenous leukemia. After anti-leukemic chemotherapy, she suffered from pneumoniae with pleural effusions and severe hypoxia, which did not respond to antibiotics. At this point, her serum sample showed positive Aspergillus antigen by Pastorex Aspergillus. She was treated by intensive antifungal chemotherapy, and thereafter improved quickly. Titers of Pastorex Aspergillus were well correlated with her clinical course. The sensitivity of the test requires further improvement, but the specificity of the test is considered to be high enough for clinical use.
[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.
[A case of organizing pneumonia which had to be treated with steroids in the early phase of the disease against delayed resolution of severe pneumonia occurring even after antibiotic therapy].
A 58-year-old male was referred to our division because of antibiotic-resistant pneumonia. A chest X-ray film revealed severe pneumonia over the left lung field but laboratory data showed no leukocytosis. Transbronchial lung biopsy findings showed the evidence consistent with organizing pneumonia. One-month prednisolone therapy produced a disappearance of the pneumonia shadow, but a giant bulla was found at the same site. It was considered that it was necessary to treat this case with a combination of effective antibiotics and steroids in the early phase of the disease.
[Development of serodiagnostic kit "HITAZYME Chlamydia Ab" for Chlamydia trachomatis infections using extracted antigen].
To develop EIA kit with low cross-reactivity for the quantitative detection of anti-chlamydial antibodies, we examined the preparation of trachomatis antigens and its specificity to mouse antisera and human sera. The chlamydial elementary body (EB) purified from C. trachomatis L2/434/Bu strain was treated by Sarkosyl, dithiothreitol and SDS by turns to obtain the soluble EB outer membrane (COMC). SDS-PAGE showed that the major components of the COMC were 96K, 60K and 39.5 KDa peptides. The reactivity of the COMC immobilized to 96 wells microtiter plate to mouse anti-serum to C. trachomatis was higher than the other two mouse anti-sera to C. psittaci and pneumoniae. In human sera, the cut off values were calculated from an average optical density plus its two-fold standard deviation obtained by the testing of 100 samples of healthy human sera. We evaluated the specificity of the kit to 17 anti-C. pneumoniae, 9 C. trachomatis and 4 C. psittaci antibodies positive patients' sera judged by the MFA method respectively. The results showed that the concordance ratio of IgG and IgA were 88%, 100% in anti-C. pneumoniae, 89%, 78% in anti-C. trachomatis and 50%, 50% in anti-C. psittaci respectively. From the results obtained in this study, we concluded that the HITAZYME method which had a very low cross-reactivity to C. pneumoniae is clinically useful in the serodiagnosis of C. trachomatis infections, even if it has a little common antigenicity with C. psittaci antigen.
Stimulants from gardeniae fructus for cultured endothelial cell proliferation.
Bioassay-guided fractionation of Gardeniae Fructus extract (GFE), which stimulates the proliferation of cultured endothelial cells, led to the isolation of glycerol and D-mannitol. Both compounds significantly increased the incorporation of [3H]thymidine and [14C]leucine into the acid-insoluble fraction of bovine aortic endothelial cell layers in culture. This clearly indicated that glycerol and D-mannitol are active components of GFE on endothelial cell proliferation. On the other hand, they did not change the number of cultured vascular smooth muscle cells from bovine aorta. Glycerol and D-mannitol may be beneficial drugs for vascular disorders.
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.
Quinolone antimicrobial agents and theophylline.
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Roxithromycin does not raise serum theophylline levels.
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Host defense activity in various hosts. Human neutrophil NADPH oxidase activity.
The superoxide generation of neutrophil NADPH oxidase from healthy subjects, patients with respiratory infections, and patients receiving effective therapy with antibiotics or steroids was investigated. In young healthy nonsmokers the mean oxidase activity of neutrophils in women was significantly lower than that in men. In healthy women the mean oxidase activity was significantly lower in young nonsmokers than in young smokers or the elderly. In young nonsmokers, oxidase activity significantly increased during respiratory infections; however, in elderly nonsmokers, no significant increase in oxidase activity was observed during respiratory infections. The mean oxidase activity in patients receiving steroids was very low. In in vitro experiments using cell-free activation systems of NADPH oxidase, steroids were found to injure the membrane-bound components of the oxidase enzyme. These results suggest that decreased superoxide generation in patients receiving steroids may result from steroid-induced damage in the membrane-bound components of the NADPH oxidase system. The inhibitory effect of steroids on superoxide production may reduce bactericidal action of neutrophils, ie, one defense mechanism of the body against many kinds of pathogens. Therefore, long-term therapy with steroids in the elderly should be avoided at all costs.